髌内侧支持带
Retinaculum mediale patellae
定义
股四头肌肌腱的内侧和外侧部分沿髌骨两侧向下走行，分别止于胫骨上端结节两侧；如上所述，这些部分融入关节囊，形成髌骨内侧和外侧支持带。
髌骨内侧支持带被认为是一种复合结构，包含多个有助于髌骨稳定性的组成部分。它由髌股内侧韧带（MPFL）、髌胫内侧韧带（MPTL）、髌半月板内侧韧带（MPML）以及股内侧肌斜头（VMO）的纤维扩展部分组成。[1-3]
髌股内侧韧带是对抗髌骨外向移位的主要稳定结构，起自股骨内侧髁，延伸至髌骨内侧缘。它有两个起点：一个是来自股骨内上髁与收肌结节之间骨性沟槽的横行起点，另一个是来自浅层内侧副韧带近端缘的斜行起点。[4] 髌股内侧韧带纤维亦与VMO肌腱相互交织。[4-5]
髌胫内侧韧带和髌半月板内侧韧带为次级稳定结构。MPTL附着于胫骨内侧近端的骨性嵴，而MPML附着于半月板，并与MPTL共享髌骨侧的共同附着点。[1][3] 这些韧带主要在膝关节较大屈曲角度时发挥功能。[6]
髌骨内侧支持带还包括深层关节囊层，其中含有与MPML相关的大量支持带纤维。[7] 这一复合结构确保了髌骨的内侧稳定性，防止髌骨向外侧移位，并对膝关节的整体功能发挥重要作用。
參考資料
1.Quantitative and Qualitative Analysis of the Medial Patellar Ligaments: An Anatomic and Radiographic Study.Kruckeberg BM, Chahla J, Moatshe G, et al.The American Journal of Sports Medicine. 2018;46(1):153-162. doi:10.1177/0363546517729818
2.Descriptive and Dynamic Study of the Medial Patellofemoral Ligament (MPFL).Decante C, Geffroy L, Salaud C, et al.Surgical and Radiologic Anatomy : SRA. 2019;41(7):763-774. doi:10.1007/s00276-019-02234-7.
3.Cadaveric Study of the Secondary Medial Patellar Restraints: Patellotibial and Patellomeniscal Ligaments.Kaleka CC, Aihara LJ, Rodrigues A, et al.Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA. 2017;25(1):144-151. doi:10.1007/s00167-016-4322-8.
4.The Anatomy of the Medial Patellofemoral Ligament.Baldwin JL.The American Journal of Sports Medicine. 2009;37(12):2355-61. doi:10.1177/0363546509339909.
5.Anatomic Study of the Attachment of the Medial Patellofemoral Ligament and Its Characteristic Relationships to the Vastus Intermedius.Mochizuki T, Nimura A, Tateishi T, et al.Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA. 2013;21(2):305-10. doi:10.1007/s00167-012-1993-7.
6.Recognition of Evolving Medial Patellofemoral Anatomy Provides Insight for Reconstruction.Tanaka MJ, Chahla J, Farr J, et al.Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA. 2019;27(8):2537-2550. doi:10.1007/s00167-018-5266-y.
7.Evaluation of the Medial Soft-Tissue Restraints of the Extensor Mechanism of the Knee.Conlan T, Garth WP, Lemons JE.The Journal of Bone and Joint Surgery. American Volume. 1993;75(5):682-93. doi:10.2106/00004623-199305000-00007.
8. This definition incorporates text from a public domain edition of Gray's Anatomy (20th U.S. edition of Gray's Anatomy of the Human Body, published in 1918 – from http://www.bartleby.com/107/).
