Mesh expansion release of the lateral patellar retinaculum during total knee arthroplasty.
BACKGROUND
Release of the lateral patellar retinaculum can be used to treat patellofemoral instability and to balance the extensor mechanism during knee replacement operations. However, conventional lateral release disrupts the integrity of the lateral knee capsule, may damage the blood supply to the patella, and is associated with several other potential complications. Mesh expansion release of the lateral patellar retinaculum was developed to achieve the goal of lateral release and to reduce the potential for postoperative morbidity.


METHODS
Thirteen consecutive knees in eleven patients were treated with mesh expansion lateral release during a total knee arthroplasty and were evaluated after a minimum duration of follow-up of two years. The mesh release technique consisted of multiple, longitudinal, parallel 5 to 10-mm stab incisions to mesh and expand the lateral patellar retinaculum and thereby medialize the patella in the trochlear groove of the femoral implant.


RESULTS
Mesh expansion lateral release balanced the extensor mechanism in each knee, maintained the mechanical integrity of the lateral capsule, and avoided disruption of the lateral genicular blood supply to the patella. After a minimum duration of follow-up of two years, no complications had been noted in association with mesh expansion lateral release.


CONCLUSIONS
Mesh expansion release of the lateral patellar retinaculum effectively balanced the patellofemoral joint during total knee arthroplasty, maintained the integrity of the lateral capsule, and preserved the lateral genicular blood supply.
Healy
William L
WL
Department of Orthopaedic Surgery, Lahey Clinic Medical Center, Burlington, Massachusetts 01805, USA.
Iorio
Richard
R
Warren
Paul
P
D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017746:Joint Capsule / Q000503:physiopathology / Q000601:surgery; D007593:Joint Instability / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D016059:Range of Motion, Articular / Q000502:physiology; D020127:Recovery of Function / Q000502:physiology; D013526:Surgical Mesh; D013710:Tendons / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors