Long-term functional outcome after lateral patellar retinacular release in adolescents: an observational cohort study with minimum 5-year follow-up

Abstract

Background: Lateral patellar retinacular release has been recommended for patients with patellar tilt, tight lateral retinaculum, patellar subluxation, patellar dislocation, and patellofemoral pain. Studies of long-term outcomes after lateral release are limited, especially for differing indications.

Hypothesis: Adolescents do well after lateral retinacular release in the 5- to 22-year time frame.

Methods: Patients having undergone lateral retinacular release between the years of 1981 and 1999 were contacted. Evaluation was by the Cincinnati and Lysholm scales and by level of satisfaction and need for reoperation.

Results: One hundred forty knees were studied. Mean age at operation was 15.4 years (SD, 2.7 years). Average follow-up was 8.5 (SD, 4.1 years; range, 5.2-22.5 years). Twenty-five patients had needed reoperation, indicating failure of the index operation. Kaplan-Meier survivorship was 78% at 15 years. Cincinnati and Lysholm scores indicated well-functioning knees in those not requiring reoperation. Overall satisfaction improved as time from operation increased. Comparisons were made between the group requiring reoperation and those who did not. Focus was placed on knees with patellar maltracking or tilt versus patellar instability and between males and females. No differences were found among groups for reoperation rate, level of satisfaction, average Lysholm score, or average Cincinnati score. There were no differences in demographics or outcome measures between patients with patellar instability and those with tilt. Instability patients trended toward higher reoperation rates than did tilt patients, but the difference was not significant. There were no differences between males and females.

Conclusion: The majority of patients are satisfied with their knee 5 to 22 years after lateral patellar retinacular release and scored well on questions rating knee health and function.