Lateral patellar retinacular release: changes over the last ten years

Abstract

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.

The Outcomes of Isolated Lateral Release in Patellofemoral Instability: A Systematic Review and Meta-Analysis

“…This is in contrast to the current opinion that lateral release should be reserved as an adjunct procedure to other realignment procedures and should not be used in isolation. [7][8][9]11 One of the main reasons for the hesitancy in performing isolated lateral release stems from the perception that lateral release fairs inferiorly as compared with other procedures. 8,9,11 However, this review identified that the rate of recurrent patellofemoral dislocation after isolated lateral release postoperatively is 14.1%, which is comparable to the 1.2 to 10.5% rate of recurrence reported by other reviews for the realignment procedures.…”

“…[8][9][10] Over the years, however, there have been conflicting reports regarding the outcomes of lateral release when used in the management of patellofemoral instability. [7][8][9]11 Some authors have described good outcomes after isolated lateral release for patellofemoral instability, whereas others have shown inferior outcomes with longer follow-up or when compared with other procedures. [7][8][9]11 Due to these conflicting outcomes, many studies and authors have therefore been hesitant to perform lateral release as an isolated procedure and have often advocated its use together with other concomitant procedures.…”

“…[7][8][9]11 Some authors have described good outcomes after isolated lateral release for patellofemoral instability, whereas others have shown inferior outcomes with longer follow-up or when compared with other procedures. [7][8][9]11 Due to these conflicting outcomes, many studies and authors have therefore been hesitant to perform lateral release as an isolated procedure and have often advocated its use together with other concomitant procedures. [7][8][9]11 Despite this, there is actually no systematic review or meta-analysis available that has attempted to pool together these apparently conflicting outcomes of isolated lateral release to determine whether the outcomes are indeed unsatisfactory.…”

Open Versus Arthroscopic Release for Lateral Patellar Compression Syndrome: A Randomized Control Trial

“…[7][8][9][10][11][12][13][14][15][16][17][18][19] Many studies compared arthroscopic lateral release with lateral repair for treatment of lateral patellar compression syndrome but limited studies compared open retinacular release with arthroscopic release for lateral patellar compression syndrome. [20][21][22] There was no randomized control trial for comparing open and arthroscopic lateral retinacular release for lateral patellar compression syndrome regarding functional outcome, duration of surgery, postoperative hospital stays, intra-operative and post-operative complications of hemarthrosis, infection, recurrence and medial patellar instability with 2 years of follow up so we planned our study for this purpose.…”

Use of Hyaluronic Acid Injection after Arthroscopic Release in Lateral Patellar Compression Syndrome with Degenerative Cartilage Changes: Randomized Control Trial

“…In such syndrome, there is increased patellofemoral joint pressure and venous engorgement of the patella and this can lead to degenerative cartilage changes. [1][2][3] After failure of conservative treatment for lateral patellar compression syndrome, lateral patellar retinacular release is a surgical option, which can be done arthroscopically in selected patients. [4][5][6][7][8] Hyaluronic acid is a natural component of the synovial uid and responsible for its elastic features and function of articular surfaces [9,10].…”