Abstract
Purpose
To elucidate the outcomes of lateral retinaculum plasty versus lateral retinacular release with concomitant medial patellofemoral ligament (MPFL) reconstruction.
Methods
In a prospective study, 59 patients treated at our institution from 2012 to 2014 were included. The 59 patients were randomly divided into two groups. Group I included 27 patients who underwent lateral retinacular release and MPFL reconstruction. Group II included 32 patients who underwent lateral retinaculum plasty and MPFL reconstruction. All patients were followed up for at least 2 years and all assessments were performed both pre- and post-operation. Clinical evaluation consisted of the Kujala score, patellar medial glide test, and patellar tilt angle, patellar lateral shift, and congruence angle, measured on CT scan.
Results
Significant improvement was seen after surgery in both groups. The group of lateral retinaculum plasty achieved better results than the group of lateral retinacular release. No statistically significant differences were found in lateral patellar shift (ns) or congruence angle (ns) between the groups. There were significant differences in Kujala score (P < 0.05) patellar tilt angle (P < 0.05), and patellar medial glide test (P < 0.05) between the groups.
Conclusions
MPFL reconstruction with lateral retinaculum plasty yielded better results than MPFL with lateral retinacular release. Postoperatively, medial and lateral function were restored, and patellar tracking was normal. Lateral retinaculum plasty is a new method that reduces the complications of lateral retinacular release for patellar dislocation.
Level of evidence
II.
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Abbreviations
- LRR:
-
Lateral retinacular release
- LRP:
-
Lateral retinaculum plasty
- MPFL:
-
Medial patellofemoral ligament
- MPG:
-
Medial patellar glide test
References
Amis AA, Firer P, Mountney J, Senavongse W, Thomas NP (2003) Anatomy and biomechanics of the medial patellofemoral ligament. Knee 10:215–220
Arendt EA, Dejour D (2013) Patella instability: building bridges across the ocean a historic review. Knee Surg Sports Traumatol Arthrosc 21:279–293
Biyani R, Elias JJ, Saranathan A, Feng H, Guseila LM, Morscher MA, Jones KC (2014) Anatomical factors influencing patellar tracking in the unstable patellofemoral joint. Knee Surg Sports Traumatol Arthrosc 22:2334–2341
Christiansen SE, Jacobsen BW, Lund B, Lind M (2008) Reconstruction of the medial patellofemoral ligament with gracilis tendon autograft in transverse patellar drill holes. Arthroscopy 24:82–87
Christoforakis J, Bull AM, Strachan RK, Shymkiw R, Senavongse W, Amis AA (2006) Effects of lateral retinacular release on the lateral stability of the patella. Knee Surg Sports Traumatol Arthrosc 14:273–277
Conlan T, Garth WP Jr, Lemons JE (1993) Evaluation of the medial soft-tissue restraints of the extensor mechanism of the knee. J Bone Joint Surg Am 75:682–693
Deie M, Ochi M, Sumen Y, Adachi N, Kobayashi K, Yasumoto M (2005) A long-term follow-up study after medial patellofemoral ligament reconstruction using the transferred semitendinosus tendon for patellar dislocation. Knee Surg Sports Traumatol Arthrosc 13:522–528
Dejour H, Walch G, Nove-Josserand L, Guier C (1994) Factors of patellar instability: an anatomic radiographic study. Knee Surg Sports Traumatol Arthrosc 2:19–26
Desio SM, Burks RT, Bachus KN (1998) Soft tissue restraints to lateral patellar translation in the human knee. Am J Sports Med 26:59–65
Feller JA, Richmond AK, Wasiak J (2014) Medial patellofemoral ligament reconstruction as an isolated or combined procedure for recurrent patellar instability. Knee Surg Sports Traumatol Arthrosc 22:2470–2476
Ficat P, Ficat C, Bailleux A (1975) External hypertension syndrome of the patella. Its significance in the recognition of arthrosis. Rev Chir Orthop Reparatrice Appar Mot 61:39–59
Fulkerson JP, Gossling HR (1980) Anatomy of the knee joint lateral retinaculum. Clin Orthop Relat Res 183–188
Henry JH, Goletz TH, Williamson B (1986) Lateral retinacular release in patellofemoral subluxation. Indications, results, and comparison to open patellofemoral reconstruction. Am J Sports Med 14:121–129
Hughston JC, Deese M (1988) Medial subluxation of the patella as a complication of lateral retinacular release. Am J Sports Med 16:383–388
Ji G, Wang F, Zhang Y, Chen B, Ma L, Dong J (2012) Medial patella retinaculum plasty for treatment of habitual patellar dislocation in adolescents. Int Orthop 36:1819–1825
Johnson RP (1989) Lateral facet syndrome of the patella. Lateral restraint analysis and use of lateral resection. Clin Orthop Relat Res 238:148–158
Kang HJ, Wang F, Chen BC, Su YL, Zhang ZC, Yan CB (2010) Functional bundles of the medial patellofemoral ligament. Knee Surg Sports Traumatol Arthrosc 18:1511–1516
Kolowich PA, Paulos LE, Rosenberg TD, Farnsworth S (1990) Lateral release of the patella: indications and contraindications. Am J Sports Med 18:359–365
Laurin CA, Dussault R, Levesque HP (1979) The tangential X-ray investigation of the patellofemoral joint: X-ray technique, diagnostic criteria and their interpretation. Clin Orthop Relat Res 16–26
Merican AM, Amis AA (2008) Anatomy of the lateral retinaculum of the knee. J Bone Joint Surg Br 90:527–534
Merican AM, Kondo E, Amis AA (2009) The effect on patellofemoral joint stability of selective cutting of lateral retinacular and capsular structures. J Biomech 42:291–296
Merican AM, Sanghavi S, Iranpour F, Amis AA (2009) The structural properties of the lateral retinaculum and capsular complex of the knee. J Biomech 42:2323–2329
Nomura E, Horiuchi Y, Kihara M (2000) A mid-term follow-up of medial patellofemoral ligament reconstruction using an artificial ligament for recurrent patellar dislocation. Knee 7:211–215
Nomura E, Inoue M, Kobayashi S (2007) Long-term follow-up and knee osteoarthritis change after medial patellofemoral ligament reconstruction for recurrent patellar dislocation. Am J Sports Med 35:1851–1858
Nonweiler DE, DeLee JC (1994) The diagnosis and treatment of medial subluxation of the patella after lateral retinacular release. Am J Sports Med 22:680–686
O’Neill DB (1997) Open lateral retinacular lengthening compared with arthroscopic release. A prospective, randomized outcome study. J Bone Joint Surg Am 79:1759–1769
Ostermeier S, Holst M, Hurschler C, Windhagen H, Stukenborg-Colsman C (2007) Dynamic measurement of patellofemoral kinematics and contact pressure after lateral retinacular release: an in vitro study. Knee Surg Sports Traumatol Arthrosc 15:547–554
Pagenstert G, Wolf N, Bachmann M, Gravius S, Barg A, Hintermann B, Wirtz DC, Valderrabano V, Leumann AG (2012) Open lateral patellar retinacular lengthening versus open retinacular release in lateral patellar hypercompression syndrome: a prospective double-blinded comparative study on complications and outcome. Arthroscopy 28:788–797
Sallay PI, Poggi J, Speer KP, Garrett WE (1996) Acute dislocation of the patella. A correlative pathoanatomic study. Am J Sports Med 24:52–60
Sanchis-Alfonso V, Montesinos-Berry E (2015) Is lateral retinacular release still a valid surgical option? From release to lengthening. Ann Transl Med 3:301
Sanders TG, Morrison WB, Singleton BA, Miller MD, Cornum KG (2001) Medial patellofemoral ligament injury following acute transient dislocation of the patella: MR findings with surgical correlation in 14 patients. J Comput Assist Tomogr 25:957–962
Saper MG, Shneider DA (2015) Medial patellar subluxation: diagnosis and treatment. Am J Orthop (Belle Mead NJ) 44:499–504
Schottle PB, Fucentese SF, Romero J (2005) Clinical and radiological outcome of medial patellofemoral ligament reconstruction with a semitendinosus autograft for patella instability. Knee Surg Sports Traumatol Arthrosc 13:516–521
Scuderi G, Cuomo F, Scott WN (1988) Lateral release and proximal realignment for patellar subluxation and dislocation. A long-term follow-up. J Bone Joint Surg Am 70:856–861
Shah JN, Howard JS, Flanigan DC, Brophy RH, Carey JL, Lattermann C (2012) A systematic review of complications and failures associated with medial patellofemoral ligament reconstruction for recurrent patellar dislocation. Am J Sports Med 40:1916–1923
Shellock FG, Mink JH, Deutsch A, Fox JM, Ferkel RD (1990) Evaluation of patients with persistent symptoms after lateral retinacular release by kinematic magnetic resonance imaging of the patellofemoral joint. Arthroscopy 6:226–234
Small NC (1989) An analysis of complications in lateral retinacular release procedures. Arthroscopy 5:282–286
Smith TO, Walker J, Russell N (2007) Outcomes of medial patellofemoral ligament reconstruction for patellar instability: a systematic review. Knee Surg Sports Traumatol Arthrosc 15:1301–1314
Zhang QC, Wang SF, Fu XS (2015) Arthroscopic medial patellofemoral ligament reconstruction combined with lateral retinacular release for recurrent patellar dislocation. Zhongguo Gu Shang 28:599–602
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Liu, C., Duan, G., Niu, Y. et al. Lateral retinaculum plasty instead of lateral retinacular release with concomitant medial patellofemoral ligament reconstruction can achieve better results for patellar dislocation. Knee Surg Sports Traumatol Arthrosc 26, 2899–2905 (2018). https://doi.org/10.1007/s00167-017-4798-x
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DOI: https://doi.org/10.1007/s00167-017-4798-x