No abstract

This study reviews 34 of 37 original patients who were reviewed in 1981 after previously undergoing percutaneous lateral retinacular release. Short-term satisfactory results regarding reduction of pain and prevention of dislocation were maintained on this second followup (average, 48 months). With this increase in postoperative time, patients with recurrent subluxation developed an increase in patellar slipping. Patients with chondromalacia and degenerative joint disease are less suited for long-term treatment. Long-term problems occurred in 1 of 34 patients (3%).

This retrospective study reviews 43 patients with osteoarthritis of the knee who underwent arthroscopic surgery, from January 1979 until April 1982. Percutaneous drilling of an osteochondral defect in the femoral condyle was performed in 22 patients to relieve the high intraosseous pressure and rest pain associated with this disease; successful results were recorded in 80% of patients at an average followup of 25.1 months. Partial meniscectomy was performed in 21 patients to remove an obstructing degenerative meniscal tear; 81% had successful results with an average followup of 40.6 months. There were no postoperative complications. Percutaneous drilling and excision of degenerative meniscal tears can be valuable arthroscopic procedures in properly selected patients with osteoarthritis of the knee.

A lateral retinacular release performed through a 2 ½-3 cm lateral parapatella incision can give rewarding results for patients with chondromalacia, degenerative joint disease, recurrent subluxation or recurrent dislocation of the patella. A retrospective review from August 1978 to December 1980 of 37 patients (42 knees) shows 83% excellent or satisfactory results, 17% unsatisfactory results with an average postoperative follow-up of 12.3 months. Preoperative pain was reduced in all but two patients; no patient was made worse by the procedure with respect to pain or function. In 17 knees with recurrent dislocation of the patella there were no recurrences of dislocation. Patients having Class IV chondromalacia, considered degenerative joint disease of the patellofemoral joint, and those patients over 35 years of age had the poorest results. One hemarthrosis was the only immediate postoperative complication. Four patellectomies and one recurrent medial subluxation were the long-term failures. Comparison with the results of other treatment methods - including patella shaving, patella curettage and drilling, patellectomy, patellar prosthesis, and realignment procedures- shows the results of the percutaneous lateral retinacular release to compare favorably within the limitations of short-term follow-up.