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Lateral Retinacular Release Isn't For Everyone

This is part two of a study started in 1986. The doctors decided to extend the study to look at results five to 12 years after lateral retinacular release (LRR). The lateral retinaculum is a band of fibrous tissue along the outer edge of the kneecap (patella).

A LRR is done to decrease pressure on the patella. In a LRR the surgeon cuts through the retinaculum, the joint capsule, and the attached synovial tissue. Two groups of patients were included. Group one had knee pain but a stable patella. Group two had signs of patellar instability.

Previous studies have shown that the good effects of LRR may not last. Patients with instability may end up with patellar subluxation. This means the patella doesn't track evenly in its groove over the femur (thigh bone). Instead, it slides too far to the outside. The authors say it's likely the results are so variable because LRR is not suitable for all patients with knee pain.

The results of this study show group one kept their good results over the long term. Patients with instability (group two) had a major decrease in results. Results went from 72 percent satisfactory down to 50 percent. Group one was able to return to previous levels of sports and activity. Group two did not.

The authors conclude that LRR is best used for patients with a tight retinaculum in a painful but stable patella. LRR has the best results when followed by a rehab program to regain muscular control of patellar tracking.

Alfredo Schiavone Panni, MD, et al. Long-term Results of Lateral Retinacular Release. In Arthroscopy. May 2005. Vol. 21. No. 5. Pp. 526-531.


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