Patella Tracking Issues - lateral release?

[muscleflex]

Long story short - been having knee problems for years, have tried meds, physio, cortisone, synvisc and most recently a failed microfracture surgery. Doctor is now recommending a lateral release and possibly (if that doesn't work) a tibial tubercle osteotomy? Wondering if anyone has experience with either of these surgeries (mainly the lateral release) or what - if anything - worked for others who have patella tracking issues. Thanks!

[tinydinosaur]

lateral release attempts to correct tracking issues by inducing more instability, i would get a second or third opinion if i were you. TTT doesn't generally have much better results.

exhaust all non-surgical options first. see either a sports physio or an athletic therapist (someone trained in correcting muscle imbalance for your whole lower half, not just looking at quad/VMO), if you are still having trouble then some people do end up getting either an MPFL recon or an LPFL recon (depending on the side you are maltracking to).

That really depends also on your pain level and functionality. If you are curious you can google 'lateral release outcomes' - people with patellar instabilities / tracking problems have worse outcomes over time than those who get a LR and have pain but no instability.

[Sam451]

I've had both procedures and I'm a mess now. The lateral release didn't work so they did the TTT. After this I started having medial dislocations. These are far worse than any of the lateral tracking issues I ever had. They have done both a repair and reconstruction of the lateral retinaculum with no success. They finally did a revision of the TTT moving it back laterally some as well as tightened the lateral retinaculum again and while it helped it hasn't stopped the medial tracking issues. I am now at a point where they are considering a trochleoplasty or knee replacement. I have had 10 surgeries over the course of 6 years. My knee is a mess. I just want to be able to walk without fear of falling. While I was falling a minimum of 10 times a day and up to 20 or more, the revision of the TTT stopped that and it's occurring only a few days a week. Sometimes a bad day it happens all day but then it won't happen the rest of the week, where prior to the revision it was daily and progressively got worse.

Be very thorough in your research and get several opinions before making the decision. I have other issues that lead to this situation. I had OATs done and revised I've had ligament reconstruction where the screw holes never filled in with bone and now I'm dealing with stress fractures in both tibia and femur so it seems nothing has gone my way and if it can go wrong it has sadly. I was a very healthy woman prior to the injury. Ate great and worked out 5-6 days a week and was training for marathons.

Now I am 44 and I just want to walk and not need a brace and a cane.

I think I have a worse case scenario but have talked with a few people who have had similar outcomes. So really try every other option first. If those don't work you have to do what you have to do. Just know there are possible issues that can arise from both that can make you knee worse than it was. Though there are people who have had tremendous success with the TTT. I would NOT recommend the lateral release as I have had too many issues because of it. That is just my experience though.

[kchan808]

I had a Lateral release done 12 years ago because it sounded the easiest way to fix me up. No bones being cut etc. But that was the only options I had back then. 2 years after the lateral release I still dislocated. What a failure. I pretty much just lived with it because I was worried that if I had surgery again it would make it worse or fail again. Just recently I ended up getting a trochleoplasty followed by an mpfl by Lars Blond. He explained to me about the trochlea being shallow and how the surgery can help me. It has been 2 years post op. Probably the longest I have gone without dislocating. Contact him through email or phone. Have him look at your MRI images to see what it is you really need. It changed my life for sure. I mean why would you want to have a lateral release done. If it fails have a TTO. Then if that fails what do you do then. Seriously this is your Knee and whatever you do to it you can't take back. http://www.larsblond.com/

[plaidwandering]

If you've already done muscle rebalancing PT, have you had/looked into prolotherapy? A good Dr. that does that should be able to take the description of the tracking problem and inject the lagging spots