Lateral release

Ligament, tendon and fibrous tissue stays hold the normal patella in a central position. Sometimes the tissues are too tight on the lateral side, and pull the patella into a poor position.

The lateral release procedure attempts to re-position the patella in a better position by cutting the tissues on the lateral side.

• What does a lateral release entail?
• Lateral release can be problematic
• Forum discussions

What does a lateral release entail?

The patella is supported on both sides by the fibrous retinacula, the most important of which is the lateral retinaculum. Sometimes the retinaculum is too tight on the lateral side and this results in 'patellar tilt', excessive lateral pressure syndrome and anterior knee pain.

In the procedure of lateral release, which is nowadays usually performed arthroscopically from inside the joint, the retinaculum is cut on the lateral (outer) side of the knee, allowing the patella to move into a better position.

Back to top

Lateral release can be problematic

The lateral release procedure is being performed less frequently and for more stringent indications, where it was in the past performed fairly indiscriminately for several problems relating to the patella.

If performed for the wrong indication, it may lead to real kneecap instability, and instability may be to the medial side rather than the more common lateral side. Surgeons nowadays - where there is a clear indication - may recommend a lateral retinacular lengthening rather than a lateral release.

Peer-reviewed papers

• Quote from peer-reviewed paper:

  "We frequently hear these words when talking about....[lateral retinacular release]: “I am going to perform a very minor surgery that can do you no harm, and still leaves the door open for more aggressive realignment procedures”. There is nothing further from the truth. This way of thinking is a big mistake..."

  Citation: Sanchis-Alfonso V, Montesinos-Berry E. Is lateral retinacular release still a valid surgical option? From release to lengthening. Ann Transl Med. 2015 Nov;3(19):301. doi: 10.3978/j.issn.2305-5839.2015.11.15. PMID: 26697461; PMCID: PMC4671865.

• Quote from peer-reviewed paper:

  "For many years, lateral retinacular release of the patella has been used indiscriminately for the treatment of various extensor mechanism abnormalities, presenting conflicting functional results....Nowadays, there is clear evidence for its indication in the lateral patellar hypercompression syndrome associated with anterior knee pain, as long as there is no related instability"

  Citation: Fonseca LPRMD, Kawatake EH, Pochini AC. Lateral patellar retinacular release: changes over the last ten years.

End of paper Quick links

• Excessive lateral pressure syndrome

• Lateral retinacular lengthening

End of links

Back to top

Forum discussions

• FIXED my failed lateral release! (Exercises for medial patellar instability)

  A broad discussion about failure of the lateral release which resulted in medial subluxation.

• LATERAL RELEASE FAILED - VMO advancement next

  A young person struggles after failed lateral release.

• Pros & Cons of Lateral Release

  A discussion including the reputation of lateral release.

• Patella Tracking Issues - lateral release?

  Patients discuss the difficult topic of decision-making after previous surgery fails.

Back to top