Lateral release (surgery)

Lateral release is a type of orthopedic surgery primarily aimed at correcting patellar tracking disorder, where the patella (kneecap) does not move or track in its normal pathway as the knee bends and straightens. This procedure is often considered when conservative treatments for misalignment or discomfort in the knee have failed. The surgery involves cutting through tight structures on the lateral (outer) side of the knee to allow the patella to move more freely and align properly in the trochlear groove of the femur when the knee is in motion.

Indications

Lateral release surgery is typically indicated for patients experiencing chronic knee pain, instability, or misalignment of the patella that has not responded to non-surgical treatment methods such as physical therapy, bracing, or injections. Conditions such as lateral patellar compression syndrome, excessive lateral pressure syndrome, and certain forms of patellofemoral pain syndrome may be addressed with this procedure.

Procedure

The surgery is usually performed arthroscopically, which involves making small incisions around the knee and using a camera and specialized instruments to perform the release. The surgeon cuts the lateral retinaculum, a fibrous tissue that helps stabilize the patella on the outside of the knee, to relieve tension and allow the patella to track more centrally in the trochlear groove. The goal is to balance the forces pulling the patella laterally (outward) and medially (inward), improving the alignment and movement of the patella.

Recovery

Post-operative recovery from a lateral release varies among patients but generally includes a period of rest, followed by physical therapy to strengthen the muscles around the knee and improve range of motion. The use of crutches or a knee brace may be recommended initially to protect the knee as it heals. Full recovery and return to previous levels of activity can take several weeks to months, depending on the individual's condition before surgery and their commitment to rehabilitation.

Risks and Complications

As with any surgical procedure, lateral release surgery carries risks, including infection, bleeding, and the potential for increased knee instability or weakness. There is also a risk that the surgery may not fully alleviate knee pain or that the patella may become too mobile, leading to dislocation. Careful patient selection and post-operative rehabilitation are critical to minimizing these risks and achieving a successful outcome.

Conclusion

Lateral release surgery can be an effective treatment for certain conditions causing patellar misalignment and knee pain. However, it is typically considered only after conservative treatments have failed. Patients undergoing this procedure should be aware of the potential risks and the importance of post-operative rehabilitation to ensure the best possible recovery.