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TKR: Lateral Retinacular Release



- See:
    - TKR Menu
    - blood supply to the knee:
    - standard lateral retinacular release:

- Discussion:
    - at completion of TKR, patellar tracking are critically evaluated to insure stability;
          - patellar tracking may be improved by removal of patellar osteophytes and lateral retinacular release;
          - if significant preoperative valgus deformity is corrected, it may be necessary to perform lateral retinacular release to allow proper 
                 patellar tracking & prevent patellar subluxation or dislocation;
    - an attempt should be made to preserve the lateral geniculate vessels during the retinacular release, however, there is no evidence to 
          suggest interruption of the the superior geniculate artery leads to osteonecrosis of patella;
          - following the medial arthrotomy and the lateral retinacular release, the only certain blood supply left is anterior tibial recurrent artery;
    - lateral retinacular release is carried down all the way to the tibia distally and to the region approx 2 fingerbreadths proximal to patella proximally;
    - lateral geniculate arteries can be preserved by performing the retinacular from within, at least 12 mm from the patella


Anatomy of the junction of the vastus lateralis tendon and the patellae

Surgical interruption of patellar blood supply by total knee arthroplasty.

The relationship of lateral releases to patella viability in total knee arthroplasty.

Clinical, roentgenographic, and scintigraphic results after interruption of the superior lateral genicular artery during total knee arthroplasty.

Scintigraphic determination of patellar viability after excision of infrapatellar fat pad and/or lateral retinacular release in total knee arthroplasty.

Patellar retinacular peel: an alternative to lateral retinacular release in total knee arthroplasty.

Mesh Expansion Release of the Lateral Patellar Retinaculum During Total Knee Arthroplasty.

The consequences of lateral release in total knee replacement: a review of over 1000 knees with follow up between 5 and 11 years.

Postoperative patellar complications with or without lateral release during total knee arthroplasty.

Total Knee Arthroplasty Using a Pie-crusting Technique for Valgus Deformity.

Does Lateral Release Change Patellofemoral Forces and Pressures?: A Pilot Study