Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Oct 20;3(5):e633-8.
doi: 10.1016/j.eats.2014.07.004. eCollection 2014 Oct.

Diagnosis and treatment of lateral patellar compression syndrome

Michael G Saper  1 , David A Shneider  2
Affiliations

Diagnosis and treatment of lateral patellar compression syndrome

Michael G Saper et al. Arthrosc Tech. .

Abstract

Chronic anterior knee pain with a stable patella is often associated with overload and increased pressure on the lateral facet due to pathologic lateral soft-tissue restraints. "Lateral pressure in flexion" is a term describing the pathologic process of increasing contact pressure over the lateral patellar facet as knee flexion progresses. This report describes a surgical technique developed in response to lateral pressure in flexion and the shortcomings of traditional arthroscopic lateral release procedures. The technique is performed open with the knee in flexion, and the lateral release is repaired with a rotation flap of iliotibial band to close the defect and prevent patellar subluxation. The technique effectively decreases lateral patellar pressure and centers the patella correctly in the trochlear groove with minimal risk of iatrogenic patellar instability.

PubMed Disclaimer

Figures

Fig 1
Fig 1
Preoperative arthroscopic image of the patellofemoral compartment (right knee), viewed from the anterolateral portal, showing 2+ lateral patellar laxity at full knee extension.
Fig 2
Fig 2
Preoperative arthroscopic image of the patellofemoral compartment (right knee), viewed from the anteromedial portal, showing compression of the lateral facet of the patella over the lateral femoral condyle with the knee at 90° of flexion.
Fig 3
Fig 3
Right knee after a midline skin incision. Electrocautery is used to free the lateral side of the patellar tendon.
Fig 4
Fig 4
The lateral retinaculum is carefully opened at the inferolateral tip of the patella and carried only far enough proximally to allow the patella to center in the trochlear groove.
Fig 5
Fig 5
The lateral release is repaired by rotating a flap of adjacent iliotibial band to close the defect.
Fig 6
Fig 6
Right knee after lateral release, anteromedial tibial tubercle transfer, and repair of the lateral retinaculum.
Fig 7
Fig 7
Postoperative arthroscopic image of the patellofemoral articulation, viewed from the lateral portal (right knee), showing a stable patella, centered in the trochlea.
See this image and copyright information in PMC

References

    1. Sanchis-Alfonso V. Springer; London: 2006. Anterior knee pain and patellar instability.
    1. Post W.R. Anterior knee pain: Diagnosis and treatment. J Am Acad Orthop Surg. 2005;13:534–543. - PubMed
    1. Witvrouw E., Callaghan M.J., Stefanik J.J. Patellofemoral pain: Consensus statement from the 3rd International Patellofemoral Pain Research Retreat held in Vancouver, September 2013. Br J Sports Med. 2014;48:411–414. - PubMed
    1. Zaffagnini S., Dejour D., Arendt E. Springer Verlag; Berlin: 2010. Patellofemoral pain, instability, and arthritis.
    1. Larson R.L., Cabaud H.E., Slocum D.B., James S.L., Keenan T., Hutchinson T. The patellar compression syndrome: Surgical treatment by lateral retinacular release. Clin Orthop Relat Res. 1978;134:158–167. - PubMed

LinkOut - more resources