The Role of Lateral Retinacular Release in the Treatment of Patellar Instability

Abstract

In the last 2 decades many authors have described the use of an isolated lateral retinacular release for the treatment of patellar instability. This review analyzes the published long-term results of this procedure for the treatment of patellar instability. The isolated use of a lateral retinacular release of the patella has not proven to be of long-term benefit for the treatment of patellar instability. It may be used as an adjunct procedure to a proximal or distal realignment of the extensor mechanism. Various pitfalls of a lateral release for patellar instability are discussed.

Estudo anatômico do ligamento patelofemoral lateral em joelho de cadáveres

“…Como complicação dessa liberação, podemos nos deparar com a subluxação patelofemoral medial, inclusive em sua forma oculta (29) . Essa entidade pode contribuir com os maus resultados obtidos após o procedimento de liberação retinacular lateral (30) . Dessa forma, a suspeita diagnóstica de subluxação medial iatrogênica da patela deve sempre estar presente no raciocínio do ortopedista, especialmente nos casos de resultados insatisfatórios.…”

Chiropractic management of a patient with postoperative lateral retinacular release using a multimodal approach: a case report

“…Factors such as core weakness, increased valgus knee alignment, generalized ligamentous laxity, increased foot pronation, and increased femoral anteversion have shown to be factors that can contribute to anterior knee pain and patella instability. 2 In addition, weakness of the vastus medialis obliquus (VMO) is thought to be an important factor resulting in patellar subluxation and dislocation. Understanding the relationship between VMO weakness and patellar tracking may be useful in diagnosis, treatment, and prevention of patellar subluxation.…”

“…1,[4][5][6][7] During the acute stage, aspiration of effusion may allow the patient to regain quadriceps strength and control. 2 However, if a patient has a loose body after a dislocation, Colvin and West 4 recommend arthroscopy for removal or possible fixation of the fracture fragment, in which case a medial repair will usually be performed simultaneously. Nonoperative treatment includes physical therapy, focusing on strengthening of the gluteal muscles and the VMO, and patellar taping or bracing.…”

Patellar instability

“…Authors found fair results only among patients with pre-existing chondromalacia of the patella 41 . Panagopoulos et al followed 25 patients after MPFL reconstruction for an average release may be used as an adjunct to proximal or distal realignment procedures 38 . One complication of isolated lateral release is medial patellar instability.…”

“…One complication of isolated lateral release is medial patellar instability. An over-release of the lateral retinaculum may cause the patella to track excessively medially and potentially subluxate or dislocate in that direction 38 . Other complications of lateral release include post-operative infection, haematoma formation, and paradoxical worsening lateral instability.…”