The Percutaneous Lateral Retinacular Release

Abstract

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.

A Medial And Lateral Retinacular Plasty versus Medial Retinacular Plasty And Lateral Retinacular Release

“…The misuse and improper use of LRR has brought about undesirable results and complications (Sanchis-Alfonso, Montesinos-Berry et al, 2015). Nevertheless, some current studies also indicate that the overall effect of LRR is not sustainable in the long term(Betz, Lonergan et al, 1982;Dandy and Gri ths, 1989;Dandy and Desai, 1994). Desio et al(Desio, Burks et al, 1998) found that lateral patellar stability decreased by 10% at the knee exion 20° after LR released, The structure relaxation may enhance patellar instability.…”

“…An amount of factors have been demonstrated in the pathogenesis of patellofemoral instability. When combined with other factors (including dysplastic trochlear, dysplastic patella, or an abnormal Q angle, the damage of medial parapatellar soft-tissue) (Arendt, Fithian et al, 2002;Fithian, Paxton et al, 2004a;Stefancin and Parker, 2007) the isolated use of a lateral retinacular release of the patella for the therapy of patellar instability is improper (Betz, Lonergan et al, 1982;Dandy and Gri ths, 1989).…”

“…Desio et al(Desio, Burks et al, 1998) found that lateral patellar stability decreased by 10% at the knee exion 20° after LR released, The structure relaxation may enhance patellar instability. Betzet al(Betz, Lonergan et al, 1982) reported that only 29%…”