What is the role of lateral retinacular release?

Abstract

We have reviewed the literature to establish the role of lateral retinacular release in the management of disorders of the extensor apparatus of the knee. The scientific evidence for intervention is explored and reports on outcome are discussed.

Analysis of failed surgery for patellar instability in children with open growth plates

“…3) and type D lateral convexity and medial hypoplasia with additional vertical link [16]. There were 25 female and 12 male patients with a median age of 18 (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26) years. Median age at the time of primary surgery was 14 (10-16) years.…”

Acute patellar dislocation in adolescents: operative versus nonoperative treatment

“…In 12 of 14 operated knees (86%), we performed medial retinacular and capsular repair using a modified Yamamoto technique [13]. Immediate lateral retinacular release [20] was performed if arthroscopic evaluation of dynamic patellofemoral alignment showed lateral patellar tilt. Nine patients (64%) underwent arthroscopic LRR by means of an electroresector.…”

“…Therefore, primary surgery to the medial parapatellar aspect is focused on reconstructing the MPFL and surrounding soft tissues. On the other hand, the tendency towards immediate lateral retinacular release (LRR) [20] in the aforementioned studies is controversial: from "never" [21], through "in selected cases" [10,11,22], to "always" [12][13][14].…”

“…Obligatory surgical treatment of acute patellar dislocation was questioned in a retrospective analysis by Buchner et al [23], as well as in prospective randomised studies on samples of various sizes and structures by Nikku et al and Palmu et al [20,24].…”

Unique patellofemoral alignment in a patient with a symptomatic bipartite patella

“…Although it seems that the anatomy and biomechanics of the lateral retinaculum are still less well understood in contrast to the medial retinaculum from recent studies [25,26], the careful observation of this lateral structures will provide new insight for understanding the anatomy and the pathology of symptomatic bipartite patella. Moreover, recent review concluded that a lateral release including the deep transverse component of the tendon of vastus lateralis might be effective in correcting lateral patellar tilt [27]. Of note, arthroscopic VLR enables to approach directly and less invasively to the deep transverse component of the vastus lateralis compared with other procedures, such as excision or lateral retinacular release approaching from superficial layer [9,13].…”