Lateral Release Surgery
Lateral
release surgery is used to treat patella femoral syndrome and other
tracking problems with the patella. It is performed as an arthroscopic
procedure and the decision to have this surgery should come only after
failed conservative rehabilitation.
Lateral
retinacular release is the last resort for treating
patella femoral syndrome.
You may have some relief after this surgery, but it may not completely
eliminate your pain. Success of the procedure is highly dependent upon
the rehab after surgery as well as the underlying problems before
surgery.
Read on to find out more about this
procedure and if it is a good option to treat your knee pain.
Patellar
Tilt
The most common
reason for needing a lateral release is if you have lateral patellar
tilt. This means that instead of sitting directly in the femoral
groove, you patella is tilted laterally or towards the outside of your
knee.
With lateral tilt, the patella is not able
to sit in the groove normally and so you end up with pain every time
you bend your knee.
Running and jumping will
increase your knee pain and you may have popping or clicking of the
kneecap.
Lateral tilt is caused by tightness of the
lateral retinaculum, or the connective tissue that helps hold your
patella in place. If the lateral retinaculum is too tight, your patella
will tilt laterally and may cause problems.
Lateral
Riding Patella
A
lateral riding patella means that instead of sitting directly in the
groove of the femur, your patella tends to move towards the outside of
your knee.
This happens when you contract your
quads. Because the lateral retinaculum is tight, it pulls the patella
out of the groove.
You can also have a combination
of both lateral tilt and lateral riding of the patella. This can cause
increased stress on the patella, as well as pain and clicking.
Types of Patellar Malalignment
Surgical
Procedure
A lateral release is most effective in treating
either lateral tilt or a lateral riding patella. If you have either of
these problems you should have good results after your surgery.
The lateral release begins
with an arthroscopic evaluation. Your surgeon will make 2-3 small
portal incisions in order to look inside the knee joint.
They
will evaluate all of the structures including the ligaments, meniscus,
joint surfaces, and the retinaculum.
Once they
determine the best treatment, a release of the lateral
retinaculum will be performed.
They
will cut through the lateral retinaculum in order to release the
tension on the tissue. This will allow your patella to return to a
normal position.
Once the release is performed, they
will close your incisions with sutures or staples. Most surgeons will
also place a small pad with an elastic bandage on the outside of your
knee to help keep the patella from returning to its lateral position.
Recovery
Full
recovery from this knee surgery can take anywhere from 3-5 months. Most
people will be able to return to normal activities in a few weeks, and
then return to sports once their strength and balance are restored. You
may be on crutches for a few days or one to two weeks depending on your
pain levels and surgeons preference.
Rehabilitation
after a lateral release is essential for a full recovery. Because
patella femoral problems are caused by many different factors, you need
to go through a good rehab program to address any flexibility or
strength issues.
Summary
Lateral
release is a good surgical option to treat patella femoral problems
caused by lateral patellar tilt or a lateral riding patella. Rehab
after the procedure is essential for a successful outcome. The decision
to have this surgery is usually made after several weeks of
conservative rehabilitation.
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