Name of the Procedure:

Lateral Retinacular Release, Open
Common name(s): Lateral release surgery

Summary

Lateral retinacular release, open, is a surgical procedure designed to correct misalignment of the kneecap (patella) by cutting the tight lateral retinaculum tissue that is pulling the patella to the outside of the knee, thereby allowing it to move more freely and align properly.

Purpose

This procedure is performed to address patellar maltracking and lateral patellar compression syndrome. The goal is to relieve pain and improve knee function by realigning the patella and alleviating excess lateral pressure.

Indications

• Chronic knee pain from patellar maltracking.
• Lateral patellar compression syndrome.
• Recurrent patellar dislocation or subluxation.
• Failure of conservative treatments such as physical therapy and bracing.

Preparation

• Patients may be instructed to fast for a certain period before the procedure.
• Medication adjustments may be needed, particularly if the patient is on blood thinners.
• Preoperative imaging like MRI or X-rays may be required to assess knee alignment and structure.
• Pre-surgical clearance and assessments from primary care physicians, if necessary.

Procedure Description

1. Anesthesia: General or regional anesthesia is administered.
2. Incision: A small incision is made on the lateral (outer) side of the knee.
3. Release: The surgeon locates and carefully cuts the tight lateral retinacular tissue.
4. Closure: The incision is closed with sutures or staples.
5. Bandaging: The surgical site is cleaned and bandaged.

Tools used: Scalpels, scissors, sutures/staples, and surgical clamps.

Duration

The procedure typically takes about 30 to 60 minutes.

Setting

The procedure is usually performed in a hospital or surgical center.

Personnel

• Orthopedic surgeon
• Surgical nurse
• Anesthesiologist
• Operating room technician

Risks and Complications

• Infection
• Bleeding
• Nerve or blood vessel damage
• Stiffness or loss of motion in the knee
• Recurrence of symptoms or insufficient symptom relief
• Possible need for additional surgery

Benefits

• Pain relief
• Improved patellar alignment
• Enhanced knee function
• Decreased risk of further patellar dislocation

Benefits may be realized within a few weeks to several months post-surgery, depending on individual healing rates and physical therapy progress.

Recovery

• Post-surgery, patients may need crutches for a few days.
• Physical therapy is typically required to regain strength and mobility.
• Full recovery may take 6 weeks to 3 months.
• Activity restrictions include avoiding heavy lifting and excessive knee bending initially.
• Follow-up appointments to monitor healing and progress.

Alternatives

• Physical therapy and strengthening exercises.
• Bracing or taping to improve patellar tracking.
• Minimally invasive (arthroscopic) lateral retinacular release.
• Realignment surgical procedures if severe misalignment exists.

Pros and cons should be discussed with the healthcare provider to determine the best course of action.

Patient Experience

During the procedure, the patient will be under anesthesia and should not feel pain. Post-procedure, there may be pain, swelling, and discomfort at the incision site, managed with pain medication and ice packs. Physical therapy will be a crucial part of recovery, focused on restoring knee function and strength.