Outcome and experience of arthroscopic lateral retinacular release combined with lateral patelloplasty in the management of excessive lateral pressure syndrome

Abstract

Background: Only a few studies have described the effect of full arthroscopic surgery in treatment of excessive lateral pressure syndrome (ELPS). Therefore, the purpose of this study was to assess the clinical efficacy and experience of total arthroscopic lateral retinacular (LR) release and lateral patelloplasty for the treatment of ELPS.

Methods: A total of 73 patients (88 knees) with ELPS underwent arthroscopic LR release and lateral patelloplasty. The visual analogue scale (VAS), Kujala score, Lysholm scores, patella medial pushing distance, patellar tilt angle (PTA), and lateral patellofemoral angle (LPFA) were measured and evaluated before and after surgery.

Results: Follow-up ranged from 12 to 36 months with an average of 24 ± 5.8 months. The VAS was significantly lower at the last follow-up than before surgery (P < 0.01). The patella medial pushing distance, Kujala score, Lysholm score, PTA, and LPFA were significantly higher at the last follow-up than before surgery (P < 0.01, respectively). Years and lateral patella Outerbridge classification at the last follow-up have negative correlation with Kujala score, Lysholm score, Patella medial pushing distance, PTA, and LPFA (P < 0.01, respectively) and have positive correlation with VAS (P < 0.01, respectively). Related complications were not reported.

Conclusions: Full arthroscopic LR release combined with lateral patelloplasty in the treatment of ELPS is an effective minimally invasive method, which can effectively correct anomalies of force line and skeleton of patella, relieve pain, and restore knee joint motor function with less complications.

Keywords: Arthroplasty; Arthroscopic surgery; Excessive lateral pressure syndrome; Lateral patella retinaculum; Release.

Fig. 1

Cases of ELPS and follow-up period

Fig. 2

Comparison of preoperative and postoperative radiographic data of CT scan and arthroscopic examination of the ELPS patient. a Preoperative CT scan image revealed lateral articular space stenosis. b Postoperative CT scan image revealed that the lateral joint space returned to normal. c Preoperative arthroscopic examination revealed lateral articular space stenosis. d Postoperative arthroscopic examination revealed that the lateral joint space returned to normal