The patello-femoral joint :
2 Studies on Lateral Releases<-all should read - - Posted by rhea (rhea), 14 July 2003
The following are two studies done on lateral releases. The first one is what happens in the knee when a lateral release is performed and is probably why so many of them fail and end up causing more harm in the long run for many people. The second study was done on a small group of people who had lateral reconstructions (their lateral release procedure "undone"). I hope that these studies (btw both done by my OS so yes the studies are competent) help others become more educated and think twice when they come up with an OS selling a lateral release as a cure all.
Medial Patellar Instability: An Anatomical Study
INVESTIGATORS:
Dr. A. Liew, Dr. P. Fowler
SUMMARY:
The purpose was to identify landmarks for the vastus lateralis obliquus (VLO) insertion to the patella. 20 knees were dissected to identify the vastus lateralis and VLO muscles. The tendinous insertion to the patella was identified and the insertion angle and insertion height relative to the external and articular surfaces were identified. This study indicates that the VLO insertion point is in the lower half of the patella. When arthroscopic or blind lateral retinacular release is performed, the tissues are usually transected up to the level of the superior patellar pole. Given the anatomy of the VLO insertion, this in most cases would transect the VLO tendon. Loss of lateral dynamic stabilization of the patella provided by the VLO significantly contributes to medial patellar instability. To avoid this complication the anatomical characteristics of the VLO patellar tendon should be kept in mind when performing a lateral retinacular release.
http://www.fowlerkennedy.com/re_indexframe.htm
Iatrogenic Medial Patellar Instability
INVESTIGATORS:
Dr. A. Liew, Dr. P. Fowler
SUMMARY:
12 patients (14 knees) were examined because of pain and deterioration of knee function following lateral retinacular release. Medial patellar instability was diagnosed in all 12 patients based in a history of pain, medial patellar subluxation/dislocation subsequent to ;lateral retinacular release and a positive medial patellar apprehension test. A reconstruction procedure was undertaken and follow-up was done at mean of 27.4 months.11 of the 12 patients demonstrated improvement based on pain, physical examination and knee function. Decrease in pain with activities of daily living and function was significant when comparing pre-operative to post-operative scores.
PROGRESS:
This study has been presented at several scientific meetings and is in the process of being written for submission to a journal.
http://www.fowlerkennedy.com/re_indexframe.htm
Updated Sat Nov 21 2009
