Decreased ratios of lateral to medial patellofemoral forces and pressures after lateral retinacular release and gender knees in total knee arthroplasty

King, Joseph J.; Chakravarty, Rajit; Cerynik, Douglas L.; Black, Aaron; Johanson, Norman A.

doi:10.1007/s00167-012-2200-6

Cited by 17 publications

(17 citation statements)

References 46 publications

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“…21,22 Meanwhile, LRR can achieve improved patellar tracking and thus decreases retropatellar contact pressure. 8,9 Therefore, the performance of intraoperative LRR may reduce AKP after TKA.…”

Section: Discussionmentioning

confidence: 99%

“…Circumpatellar electrocautery (CE) can damage the innervation of the peripatellar soft tissues and thus reduces postoperative AKP. 1 Lateral retinacular release (LRR) can improve patellar tracking and decrease retropatellar pressure, 8,9 which may lead to a low incidence of postoperative AKP. However, the efficacy of both techniques is controversial because regardless of the use of LRR or CE, the incidence of AKP after TKA remains high.…”

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confidence: 99%

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Results of Lateral Retinacular Release Plus Circumpatellar Electrocautery in Total Knee Arthroplasty without Patellar Resurfacing

2016

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Anterior knee pain (AKP) is integral to the overall success of total knee arthroplasty (TKA) without patellar resurfacing. Numerous studies have evaluated various factors that may contribute to AKP, including patellofemoral design, surgical technique, characteristics of the patient, and degree of chondromalacia. This study aims to explore whether patients who received lateral retinacular release (LRR) plus circumpatellar electrocautery (CE) in TKA attain a low incidence of AKP and whether the LRR plus CE increases postoperative complications. Between February 2001 and February 2009, all patients undergoing TKA without patellar resurfacing and LRR plus CE were evaluated. In total, 286 TKAs in 259 (88.7%) patients were available for assessment, with a mean of 9.3 ± 2.5 years (range: 6-14 years) after the index TKA. The patients were evaluated with a VAS and the Kujala patellofemoral score (KPS) for AKP and the Knee Society's clinical scoring system (KSS) for the clinical function. Satisfaction and LRR-related complications were also assessed. The mean KPS and KSS improved from 45.2 ± 12.9 and 75.4 ± 26.8 points preoperatively to 82.8 ± 10.0 and 151.6 ± 17.3 points at the final follow-up ( < 0.001), respectively. Subjectively, 5.6% (16 of 286) of patients suffered from AKP and 88.1% (252 of 286) were satisfied or very satisfied. Postoperative complications occurred in 15 (5.2%) patients, but these complications were mild and did not require reoperation. None of patients exhibited aseptic and septic prosthesis loosening and required revision surgery in the final follow-up. LRR plus CE appears to be a reasonable option in TKA without patellar resurfacing. It may achieve adequate mid-term results, with a low incidence of AKP and postoperative complications.The level of evidence of the study is therapeutic level IV.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Results of Lateral Retinacular Release Plus Circumpatellar Electrocautery in Total Knee Arthroplasty without Patellar Resurfacing

2016

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“…Lateral retinacular release is most commonly performed on knee arthroplasties with valgus deformity to improve joint congruity, 51 , 52 , 53 , 54 , 55 decreasing the incidence of anterior knee pain, especially if the patellar component is not performed. 52 , 56 With TKA, the forces and peak pressures significantly increase in the patellofemoral joint, and lateral release may reduce the ratio of these forces and pressure in this region, 8 , 54 , 57 , 58 with low rates of complications. 51 , 55 , 56 …”

Section: Lateral Retinacular Release In Tkamentioning

confidence: 99%

Lateral patellar retinacular release: changes over the last ten years

Fonseca¹,

Kawatake²,

Pochini

2017

Revista Brasileira de Ortopedia (English Edition)

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Lateral retinacular release is a useful resource in knee surgery that can be used for disorders of the extensor mechanism. For many years, it was indiscriminately used in the treatment of the various patellofemoral joint alterations, with conflicting functional results. This study aimed to analyze the changes that have occurred in the indications and clinical effectiveness of lateral retinacular release by reviewing the relevant literature of the past ten years, comparing it to the classic literature on the subject. It was found that less extensive releases decompress the lateral patellar facet, helping with pain control, while decreasing the risks of medial subluxation. Nowadays, there is clear evidence for its indication in the lateral patellar hypercompression syndrome associated with anterior knee pain, as long as there is no related instability; furthermore, it will normally play an adjuvant role in extensor mechanism alignment surgeries for cases of recurrent patellar instability. The initial results for symptomatic patellofemoral osteoarthritis are promising when lateral release is combined with cartilage debridement; in total knee replacement, it is more commonly used for the correction of valgus deformity in order to improve the components’ congruency. Finally, distinguishing the different patellofemoral joint pathologies is seen as crucial in order to indicate this procedure. Further randomized control trials that compare surgical techniques with long-term results are still needed.

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“…11 A correct soft tissue balance is the most important factor for the durability of the prosthesis and improper release of the medial collateral ligament (MCL) may result in pain, deteriorated patellofemoral biomechanics, joint stiffness, tibiofemoral instability, polyethylene wear, osteolysis, aseptic loosening, and early implant failure. [12][13][14][15] Also, excessive soft tissue release can lead to significant mediolateral instability, and an unbalanced flexion and extension gap that may necessitate the use of a constrained prosthesis. [16][17][18] This may be a reason for the recommendation that for all TKAs without navigation or using kinematic alignment, soft tissue release must be performed and include a supporting reference for kinematic alignment not using soft tissue releases, while some authors reported only in 50 to 88% of TKAs, collateral ligament needs to be released.…”

mentioning

confidence: 99%

“…15.7%] vs. 193 females [84.3%]) with the mean age of 66.7 AE 7.93 (range ¼ 42-92). The TKA was performed on the left and right side in 129 (56.3%) and 100 (43.7%), respectively.…”

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confidence: 99%

Is Standing Coronal Long-Leg Alignment View Effective in Predicting the Extent of Medial Soft Tissue Release in Varus Deformity during Total Knee Arthroplasty?

et al. 2021

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The aim of this study was to assess the predictive value of the femoral intermechanical-anatomical angle (IMA), mechanical lateral distal femoral angle (mLDFA), medial proximal tibia angle (MPTA), femorotibial or varus angle (VA), and joint line convergence angle (CA) in predicting the stage of the medial collateral ligament (MCL) during total knee arthroplasty (TKA) of varus knee. We evaluated 229 patients with osteoarthritic varus knee who underwent primary TKA, prospectively. They were categorized in three groups based on the extent of medial soft tissue release that performed during TKA Group 1, osteophytes removal and release of the deep MCL and posteromedial capsule (stage 1); Group 2, the release of the semimembranosus (stage 2); and Group 3, release of the superficial MCL (stage 3) and/or the pes anserinus (stage 4). We evaluated the preoperative standing coronal hip-knee-ankle alignment view to assessing the possible correlations between the knee angles and extent of soft tissue release. A significant difference was observed between the three groups in terms of preoperative VA, CA, and MPTA by using the Kruskal–Wallis test. The extent of medial release increased with increasing VA and CA as well as decreasing MPTA in preoperative long-leg standing radiographs. Finally, a patient with a preoperative VA larger than 19, CA larger than 6, or MPTA smaller than 81 would need a stage 3 or 4 of MCL release. The overall results showed that the VA and MPTA could be useful in predicting the extent of medial soft tissue release during TKA of varus knee.

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Decreased ratios of lateral to medial patellofemoral forces and pressures after lateral retinacular release and gender knees in total knee arthroplasty

Abstract: Use of lateral to medial patellofemoral force ratios as a surrogate objective marker for patellar tracking was validated in this study by decreasing ratios observed after lateral release in TKA and with gender-specific implants.

Cited by 17 publications

References 46 publications

Results of Lateral Retinacular Release Plus Circumpatellar Electrocautery in Total Knee Arthroplasty without Patellar Resurfacing

Results of Lateral Retinacular Release Plus Circumpatellar Electrocautery in Total Knee Arthroplasty without Patellar Resurfacing

Lateral patellar retinacular release: changes over the last ten years

Is Standing Coronal Long-Leg Alignment View Effective in Predicting the Extent of Medial Soft Tissue Release in Varus Deformity during Total Knee Arthroplasty?

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