Lateral Retinacular Lengthening: Modifying a Forgotten Technique to Balance the Patella

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Abstract

Lateral release is no longer recommended as a single procedure for recurrent patellar instability but used as combined surgery to realign the extensor mechanism. With biomechanical studies that show the importance of preserving the lateral soft-tissue restraints, the question is whether its sectioning creates iatrogenic instability. A lateral release also does not allow fine tuning of the patellar tension to center the patella in the trochlear groove. We describe our technique that allows 1 to 3 cm of retinacular lengthening. The advantage of our technique is that the lateral capsule is usually not breached and allows fine tuning of the medial and lateral tension. This is useful in complex reconstructions for recurrent patellar instability.

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