So You’ve Mastered MPFL Reconstruction: What Else to Add, and When? (AANA22)-Lateral Retinacular Release and Lengthening in Patellar Stabilization Surgery

Lateral Retinacular Release and Lengthening in Patellar Stabilization Surgery

Video Transcription

Video Summary

The speaker discusses the lateral patellofemoral complex anatomy, focusing on the lateral patellofemoral ligament (LPFL) and lateral patella tibial ligament (LPTL), their roles in knee stability, and effects of lateral retinacular release. Lateral release reduces medial stability and can increase lateral patellar translation, so it’s not routinely indicated for isolated patellar instability but may reduce contact pressures when MPFL is over-tensioned. When combined with tibial tubercle osteotomy (TTO), lateral release decreases joint pressure but may increase instability, highlighting a balance between offloading and stability. Assessment of lateral retinaculum tightness guides surgery, with lateral retinacular lengthening preferred over release to limit medial instability. Medial instability, less common, often results from prior lateral release and requires accurate diagnosis and targeted repair or reconstruction of injured lateral structures. The speaker uses case studies to illustrate management. The session closes discussing surgical techniques, indications, and controversies around MPFL reconstruction, lateral release, and patellar stability assessment.

Asset Caption

Miho J. Tanaka, M.D., M.A.

Keywords

lateral patellofemoral complex

lateral patellofemoral ligament

lateral patella tibial ligament

lateral retinacular release

medial patellofemoral ligament reconstruction

patellar instability