This cadaveric study dissected 8 fresh-frozen human knees to define precise fluoroscopic landmarks for the femoral MPFL insertion on a true lateral radiograph. The result is the Schöttle point — a reproducible radiographic target for intraoperative guide wire placement and postoperative tunnel verification. No such radiographic guidelines existed before this paper.
Palpating the adductor tubercle and medial epicondyle through soft tissue is unreliable intraoperatively. Before this paper, there was no fluoroscopic reference to confirm correct femoral tunnel position during MPFL reconstruction.
The Schöttle point gives you a concrete intraoperative target. On a true lateral view with posterior condyles overlapped, your guide wire should land just anterior to the posterior cortical line, 2.5 mm below the posterior condylar origin, and above the Blumensaat line.
When a post-op MPFL patient has persistent medial pain or recurrent instability, pull the lateral radiograph and check tunnel position against these landmarks. A tunnel that is too proximal or too posterior explains overtensioning and medial compartment overload.
The 5-mm isometry tolerance is clinically forgiving — but only if you are in the right zone. Fluoroscopy during tunnel placement is how you confirm it.
This cadaveric study dissected 8 fresh-frozen human knees to define precise fluoroscopic landmarks for the femoral MPFL insertion on a true lateral radiograph. The result is the Schöttle point — a reproducible radiographic target for intraoperative guide wire placement and postoperative tunnel verification. No such radiographic guidelines existed before this paper.
Palpating the adductor tubercle and medial epicondyle through soft tissue is unreliable intraoperatively. Before this paper, there was no fluoroscopic reference to confirm correct femoral tunnel position during MPFL reconstruction.
The Schöttle point gives you a concrete intraoperative target. On a true lateral view with posterior condyles overlapped, your guide wire should land just anterior to the posterior cortical line, 2.5 mm below the posterior condylar origin, and above the Blumensaat line.
When a post-op MPFL patient has persistent medial pain or recurrent instability, pull the lateral radiograph and check tunnel position against these landmarks. A tunnel that is too proximal or too posterior explains overtensioning and medial compartment overload.
The 5-mm isometry tolerance is clinically forgiving — but only if you are in the right zone. Fluoroscopy during tunnel placement is how you confirm it.