LaPrade et al. performed meticulous cadaveric dissections of 8 knees using electromagnetic 3D tracking to generate the first quantitative attachment map of medial knee structures. The study defines precise distances from each ligament origin to named osseous landmarks — data that did not previously exist in the literature. A previously undescribed third femoral osseous prominence, the gastrocnemius tubercle, was identified in every specimen.
Every MPFL reconstruction and POL repair depends on finding the right femoral tunnel location — and this paper is where those coordinates come from.
When you are at the medial femoral condyle intraoperatively, there are three palpable osseous landmarks, not two. The gastrocnemius tubercle sits just distal and posterior to the adductor tubercle and marks the true POL neighborhood. Confusing it with the adductor tubercle shifts your graft proximally and anteriorly, placing it non-anatomically.
For MPFL reconstruction, aim for the adductor tubercle (1.9 mm anterior, 3.8 mm distal). Not the medial epicondyle, which sits roughly 10 mm too distal and anterior. For POL reconstruction, target the gastrocnemius tubercle region; targeting the adductor tubercle directly puts you 7.7 mm too proximal.
The central arm of the POL is the only component robust enough to reconstruct. The superficial and capsular arms are thin fascial structures that do not independently stabilize the posteromedial corner.
LaPrade et al. performed meticulous cadaveric dissections of 8 knees using electromagnetic 3D tracking to generate the first quantitative attachment map of medial knee structures. The study defines precise distances from each ligament origin to named osseous landmarks — data that did not previously exist in the literature. A previously undescribed third femoral osseous prominence, the gastrocnemius tubercle, was identified in every specimen.
Every MPFL reconstruction and POL repair depends on finding the right femoral tunnel location — and this paper is where those coordinates come from.
When you are at the medial femoral condyle intraoperatively, there are three palpable osseous landmarks, not two. The gastrocnemius tubercle sits just distal and posterior to the adductor tubercle and marks the true POL neighborhood. Confusing it with the adductor tubercle shifts your graft proximally and anteriorly, placing it non-anatomically.
For MPFL reconstruction, aim for the adductor tubercle (1.9 mm anterior, 3.8 mm distal). Not the medial epicondyle, which sits roughly 10 mm too distal and anterior. For POL reconstruction, target the gastrocnemius tubercle region; targeting the adductor tubercle directly puts you 7.7 mm too proximal.
The central arm of the POL is the only component robust enough to reconstruct. The superficial and capsular arms are thin fascial structures that do not independently stabilize the posteromedial corner.