ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2022
Arthroscopic lateral retinacular release improves patello-femoral and femoro-tibial kinematics in patients with isolated lateral retinacular tightness.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed, 6 citations in OpenAlex.
- Long-term clinical outcomes following arthroscopic lateral retinacular release with concomitant cartilage procedures in patients with isolated patellofemoral osteoarthritis: a mean 11-year follow-up study.BMC musculoskeletal disorders · 2026Article
- Lateral patellar tilting can also result in cartilage lesions of tibial plateau - the characteristic features of excessive lateral pressure syndrome: a retrospective study of 141 cases.BMC musculoskeletal disorders · 2025Article
- The patellar compression angle: a new, accurate diagnostic angle for lateral patellar compression syndrome.Journal of orthopaedic surgery and research · 2025Article
- Partial LRR over complete LRR: a preferable option - an FEA study of A - B trochlear dysplasia with critical abnormalities of patella alta and TT - TG value.Frontiers in bioengineering and biotechnology · 2025Article
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Authors and funding
8 authors at 3 institutions in 1 country.
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Abstract
purposeArthroscopic lateral retinacular release (LRR) has long been considered the gold standard for the treatment for anterior knee pain caused by lateral retinacular tightness (LRT). However, one-third of patients experience continuous pain postoperatively, which is thought to be related to persistent maltracking of the patella and altered femoro-tibial kinematics. Therefore, the aim of the present study was to simultaneously assess femoro-tibial and patello-femoral kinematics and identify the influence of arthroscopic LRR.
methodsSixteen healthy volunteers and 12 patients with unilateral, isolated LRT were prospectively included. Open MRI scans with and without isometric quadriceps contraction were performed in 0°, 30° and 90° of knee flexion preoperatively and at 12 months after surgery. Patellar shift, tilt angle, patello-femoral contact area and magnitude of femoro-tibial rotation were calculated by digital image processing.
resultsPostoperatively, patellar shift was significantly reduced at 90° of knee flexion compared to preoperative values. The postoperative patellar tilt angle was found to be significantly smaller at 30° of knee flexion compared to that preoperatively. Isometric muscle contractions did not considerably influence patellar shift or tilt in either group. The patello-femoral contact area increased after LRR over the full range of motion (ROM), with significant changes at 0° and 90°. Regarding femoro-tibial kinematics, significantly increased femoral internal rotation at 0° was observed in the patient group preoperatively, whereas the magnitude of rotation at 90° of knee flexion was comparable to that of healthy individuals. The pathologically increased femoral internal rotation at 30° without muscular activity could be significantly decreased by LRR. With isometric quadriceps contraction no considerable improvement of femoral internal rotation could be achieved by LRR at 30° of knee flexion.
conclusionsPatello-femoral and femoro-tibial joint kinematics could be improved, making LRR a viable surgical option in carefully selected patients with isolated LRT. However, pathologically increased femoral internal rotation during early knee flexion remained unaffected by LRR and thus potentially accounts for persistent pain. LEVEL OF EVIDENCE: II.
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