Lateral Retinaculum Release
Open or arthroscopic procedure on the lateral patellar retinaculum for disorders of the extensor mechanism of the knee. The procedure is designed to correct the soft tissue imbalance of the lateral retinaculum during knee extension that is associated with patellofemoral disorders and anterior knee pain.
The patellofemoral joint is inherently unstable. It relies on boney congruency and soft tissue forces to maintain stability. Soft tissue attachments to the patella contribute active stabilizing forces through the vastus medialis obliquus and passive stability through the patellofemoral ligament and the attachments of the lateral retinaculum. Imbalance occur when weakness is present in the active stabilizers and or tightness is present in the passive stabilizers. The lateral retinaculum s purpose is to resist medial displacement of the patella.
Cadaver studies concluded that a lateral release did not stabilize or medialize the patella through the entire ROM but did decrease patella pressure during flexion motion. For anterior knee pain satisfaction ranges from 14-100% dependent on a variety inclusion factors. Women tend to have worse outcomes than men. Outcomes for patella instability varies from 30-100% again dependent on selection variables during research. Lateral release for patellofemoral arthritis has been deemed result in poor outcomes.