Isolated Arthroscopic Lateral Retinacular Release for Lateral Patellar Compression Syndrome.

Filippo Migliorini,Arne Driessen,Nicola Maffulli,Markus Tingart,Christian Lüring,Filippo Spiezia,Alice Baroncini,Jörg Eschweiler

doi:10.3390/life11040295

Abstract

Introduction: Evidence concerning the role of isolated lateral retinacular release (LRR) for lateral patellar compression syndrome (LPCS) dates back at least three decades. Appropriate indications, execution and outcomes still remain unclear and controversial. The present investigation analyzed the midterm result of isolated and arthroscopic LRR for LPCS in a cohort of patients who underwent such procedure at our institution. Material and methods: Patients undergoing isolated arthroscopic LRR for LPCS were identified retrospectively from our electronic database. All procedures were performed by two experienced surgeons. Patients with bony and/or soft tissues abnormalities, patellofemoral instability, moderate to severe chondral damage were not included. Patients with previous surgeries were not included, as were those who underwent combined interventions. Clinical scores and complications were recorded. Results: 31 patients were recruited in the present investigation. The mean follow-up was 86.0 ± 22.8 months. The mean age of the patients at the index operation was 34.2 ± 13.1 years. A total 55% (17 of 31) were women, and 58% (18 of 31) had involved the right knee. The mean hospitalization length was 3.5 ± 1.4 days. At a mean follow-up of 86.0 ± 22.8 months, the numeric rating scale (NRS) was 1.2 ± 0.8, the Kujala score was 91.3 ± 11.3, the Lysholm score was 93.1 ± 15.0, and the Tegner score was 5.0 ± 1.8. At the latest follow-up, 9 of 31 (29.0%) of patients experienced compilations. One patient (3.2%) had a post-operative hemarthrosis which was managed conservatively. Six patients (19.4%) reported a persistent sensation of instability, without signs of patellar dislocation or subluxation. One patient underwent an arthroscopic meniscectomy, and another patient an anterior cruciate ligament (ACL) reconstruction. Conclusion: isolated arthroscopic lateral retinacular release for lateral patellar compression syndrome is feasible and effective, achieving satisfying results at more than seven years following the procedure.

Highlights

Evidence concerning the role of isolated lateral retinacular release (LRR)for lateral patellar compression syndrome (LPCS) dates back at least three decades
The present study reports the midterm outcomes of a cohort of patients who underwent isolated LRR for LPCS at our institution
A total of 1147 patients were excluded: patient unable to understand the nature of the treatment and the study (N = 3), previous patellar dislocation or subluxation (N = 1), previous knee surgical intervention (N = 37), elevated tibial tubercle—trochlear groove (TT-TG) (N = 3), patella alta (N =1), lower limb axis deformities (N = 7), articular chondropathy (N = 21), combination with adjuvants (N = 3), combination with other interventions (N = 1044), others (N = 3)

Summary

Introduction

For lateral patellar compression syndrome (LPCS) dates back at least three decades. The present investigation analyzed the midterm result of isolated and arthroscopic LRR for LPCS in a cohort of patients who underwent such procedure at our institution. Material and methods: Patients undergoing isolated arthroscopic LRR for LPCS were identified retrospectively from our electronic database. Lateral patellar compression syndrome (LPCS) is a common cause of patellofemoral pain [1]. LPCS present shortened and tight lateral retinaculum, combined with lateral patellar tilt [3]. This causes patellar mal-tracking, venous engorgement in the patella, and overload of lateral compartment of the patellofemoral joint [4,5,6]. Possible consequences are chondral damage, anterior knee pain and, in the long-term, patellofemoral joint osteoarthritis [1,7].

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Discussion

Conclusion