Lateral retinacular lengthening

Written by Dr Sheila Strover on March 14, 2025

Lateral retinacular lengthening is a procedure to improve patellar alignment. This is done by cutting and sliding the superficial layer of retinaculum over the deep layer to allow a controlled release of tension. Page updated May 2024 by Dr Sheila Strover (Clinical Editor)

Illustration showing cutting of the outer layer of the lateral retinaculum
The superficial layer of the lateral retinaculum is released.
Illustration of release of the deep layer of the lateral retinaculum
At a lower level, the deep layer is also released, allowing the patella to un-tilt.
Illustration of suture of the cut superficial and deep layer of the lateral retinaculae
When the patella is in a good position the two layers are sutured together in the new position.

What is the difference between lateral release and lateral retinacular lengthening?

The lateral retinacular lengthening procedure allows the surgeon to control the tension in the lateral retinaculum, so that the patella is in a better position but the lateral retinaculum is still functioning as a guy rope.

"The advantages....include controlled lengthening that maintains the continuity of the vastus lateralis (thereby decreasing quadriceps weakness and atrophy and allowing faster rehabilitation), prevention of [surgery-induced] medial instability, prevention of excessive swelling, and avoidance of egress of synovial fluid in the subcutaneous tissues...."

Derek J Hayden et al

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Lateral release, Lateral retinaculum, Vastus lateralis, Quadriceps

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