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Systematic lateral retinacular release does not reduce anterior knee pain after total knee arthroplasty with patellar resurfacing

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The aim of this study was to assess the effect of systematic lateral retinacular release (LRR) on anterior knee pain (AKP), as well as its impact on the functional and radiological outcomes after total knee arthroplasty (TKA) with patellar resurfacing.

Methods

A prospective randomized study was designed. It included patients scheduled for a TKA procedure with patellar resurfacing, who were recruited and randomized into either the LRR group or the non-release group. 198 patients were included in the final analysis. The pressure pain threshold (PPT) assessed by pressure algometry (PA), the visual analogue scale (VAS), Feller's patellar score, the Knee Society Score (KSS), patellar height, and patellar tilt were recorded both preoperatively and at the 1-year follow-up. The Mann–Whitney U test was performed to determine comparisons between both groups as well as to determine differences’ intragroup.

Results

Relative to the clinical variables and scores, no difference was detected between the two groups at the 1-year follow-up (p = n.s.). However, there was a slight difference in patellar tilt (0.1º vs. 1.4º, p = 0.044), with higher tilt values in the non-release group. There was no difference in terms of improvement in the clinical and radiological scores and variables recorded between the two groups (p = n.s.).

Conclusion

LRR in primary TKA with patellar resurfacing does not show an improvement in AKP and functional outcomes over patellar resurfacing without release.

Level of evidence

I.

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Data availability

Not applicable.

Abbreviations

AKP:

Anterior knee pain

TKA:

Total knee arthroplasty

LRR:

Lateral retinacular release

PPT:

Pressure pain threshold

PA:

Pressure algometry

VAS:

Visual analogue score

KSS:

Knee society score

PFS:

Patellofemoral feller score

SD:

Standard deviation

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Acknowledgements

The authors would like to thank Xavier Duran for his assistance in the statistical analysis. This study was conducted within the framework of a Doctorate in Surgery and Morphological Sciences of the Universitat Autònoma de Barcelona.

Funding

The authors have not received financial support for the research, authorship, and publication of this article.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Parc de Salut Mar, Hospital de la Esperanza, Universitat Autònoma de Barcelona, Sant Josep de la Muntanya 12, 08024, Barcelona, Spain

    Nerea Goicoechea, Pedro Hinarejos, Berta Gasol, Raul Torres-Claramunt, Juan Sánchez-Soler, Simone Perelli & Joan Carles Monllau

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  1. Nerea Goicoechea
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  2. Pedro Hinarejos
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  3. Berta Gasol
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  6. Simone Perelli
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Correspondence to Nerea Goicoechea.

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The study was approved by the Research Ethics Committee of our institution (2019/8993/I).

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Written informed consent was obtained from all the participants included.

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Goicoechea, N., Hinarejos, P., Gasol, B. et al. Systematic lateral retinacular release does not reduce anterior knee pain after total knee arthroplasty with patellar resurfacing. Knee Surg Sports Traumatol Arthrosc 31, 4213–4219 (2023). https://doi.org/10.1007/s00167-023-07456-2

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