Lateral retinacular release: a survey of the International Patellofemoral Study Group.
OBJECTIVE
The purpose of this investigation was to determine current views regarding lateral release among experienced knee surgeons with a specific interest in the patellofemoral joint.


METHODS
Scientific survey.


METHODS
A questionnaire was developed and mailed to all members of an international group with a specific interest in disorders of the patellofemoral joint. Frequencies and percentages of responses were calculated for each question to determine surgeon consensus. We measured agreement among responses using the kappa statistic. This provided an indication of consistency for each question as well as correlation among the responses to different questions.


RESULTS
The survey response rate was 60%. Isolated lateral release was estimated to account for only 1 to 5 surgical cases per respondent per year, or 2% of cases performed annually. In the setting of arthroscopy or exploration, 74% of respondents believed that lateral release calls for specific informed consent. Strong consensus was found that objective evidence is needed to justify lateral release, but agreement was poor as to what clinical evidence provides the most appropriate indication for the procedure.


CONCLUSIONS
Even among experienced knee surgeons with a special interest in diseases of the patellofemoral articulation, isolated lateral release is rarely performed. Strong consensus was found that isolated lateral release should not be undertaken without prior planning in the form of objective clinical indications and preoperative informed consent.


METHODS
Level V.
Fithian
Donald C
DC
Southern California Permanente Medical Group, El Cajon, California, USA. donald.c.fithian@kp.org
Paxton
Elizabeth W
EW
Post
William R
WR
Panni
Alfredo Schiavone
AS
D001182:Arthroscopy / Q000523:psychology / Q000706:statistics & numerical data; D002357:Cartilage Diseases / Q000150:complications; D002358:Cartilage, Articular / Q000473:pathology; D003238:Connective Tissue / Q000601:surgery*; D003469:Culture; D003625:Data Collection; D006801:Humans; D007258:Informed Consent; D007593:Joint Instability / Q000601:surgery; D007719:Knee Joint / Q000601:surgery*; D009985:Orthopedics; D020370:Osteoarthritis, Knee / Q000150:complications; D031222:Patellar Dislocation / Q000601:surgery; D010820:Physicians / Q000523:psychology; D010818:Practice Patterns, Physicians'; D012008:Recurrence; D011795:Surveys and Questionnaires