A lateral release is a surgical procedure to release tight capsular structures (lateral retinaculum) on the outer aspect of the knee.

Page updated Aug 2023 by Dr Sheila Strover (Clinical Editor)

retinaculum supporting the patella

 

Ligament, tendon and fibrous tissue stays hold the normal patella in a central position.

patellar tilt

 

Sometimes the tissues are too tight on one side, and pull the patella into a poor position.

lateral retinacular release

 

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?

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.

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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.

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Forum discussions

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Peer-reviewed papers

  • Quote:

    "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:

    "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.

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Synonyms: 
Lateral retinacular release
LRR
LR
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Dr Sheila Strover (Editor)
BSc (Hons), MB BCh, MBA

See biography...