Less anterior knee pain with a routine lateral release in total knee arthroplasty without patellar resurfacing: a prospective, randomized study

Knee
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Abstract

Purpose

Anterior knee pain is a major cause of complaint in total knee arthroplasty (TKA) without patellar resurfacing. The concept of improved patellar tracking and decreased retropatellar contact pressure for lateral retinacular release theoretically suggests that patients with lateral retinacular release in TKA would achieve a lower incidence of anterior knee pain when compared without lateral retinacular release. We sought to determine (1) whether those patients who received a routine lateral retinacular release in TKA would attain lower incidence of anterior knee pain as compared to patients who received TKA without lateral retinacular release and (2) whether lateral retinacular release would increase the lateral retinacular release-related complications.

Methods

A total of 148 patients who underwent TKA with the use of the Gemini MK II mobile bearing were randomized to receive either routine lateral retinacular release (intervention group) or not (control group). Patients were assessed by the visual analogue scale for anterior knee pain, the Knee Society clinical scoring system of knee score and function score, and patellar score for clinical function. Patients’ satisfaction and lateral retinacular release-related complications were also evaluated.

Results

The overall incidence of anterior knee pain in the intervention group at 18 months follow-up was 5.6 %, while that of the control group was 20.6 % (p = 0.009). No statistical difference was detected between the two groups in terms of lateral retinacular release-related complications (n.s.), patients’ satisfaction (n.s.), knee score (n.s.), function score (n.s.), and patellar score (n.s.) at 18 months follow-up.

Conclusion

The present study suggests that routine lateral retinacular release can reduce anterior knee pain and does not increase lateral retinacular release-related complications, in TKA with the use of the Gemini MK II mobile bearing without patellar resurfacing.

Level of evidence

Therapeutic, Level I.

Keywords

Lateral retinacular release Anterior knee pain Total knee arthroplasty 
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Notes

Acknowledgments

We are grateful for all patients who agreed to participate in this study. We thank Dr. Jia-Xiang Tian and Shi-Kai Zhang who evaluated the clinical data of patients.

Conflict of interest

This research was supported by the Postgraduate Innovation Project of Jiangsu Province of China (CXLX13_830). None of the authors has received or will receive benefits for personal or professional use from a commercial party related directly or indirectly to the subject of this work.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  1. 1.Orthopaedic DepartmentThe First Affiliated Hospital of Soochow UniversitySuzhouPeople’s Republic of China

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