Lateral retinaculum plasty instead of lateral retinacular release with concomitant medial patellofemoral ligament reconstruction can achieve better results for patellar dislocation

• Published in: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA Vol. 26; no. 10; pp. 2899 - 2905
• Main Authors: Liu, Chang, Duan, Guman, Niu, Yingzhen, Cao, Pengkai, Fu, Kunpeng, Niu, Jinghui, Wang, Fei
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.10.2018; Springer Nature B.V
• Subjects: Adolescent; Complications; Computed tomography; Dislocation; Dislocations; Female; Humans; Knee; Knee Joint - surgery; Male; Medicine; Medicine & Public Health; Orthopedics; Patella; Patellar Dislocation - surgery; Patellar Ligament - surgery; Patients; Postoperative Period; Prospective Studies; Recurrence; Statistical analysis; Surgery; Tomography, X-Ray Computed; Young Adult; Medial patellofemoral ligament reconstruction; Lateral retinacular release; Lateral retinaculum plasty; Patellar tracking
• ISSN: 0942-2056; 1433-7347
• DOI: 10.1007/s00167-017-4798-x

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.