Lateral retinacular release is an arthroscopic procedure to divide the tight lateral retinaculum — the band of tissue on the outer side of the kneecap — to improve patellar tracking and reduce anterior knee pain.
Performed arthroscopically. The tight lateral retinaculum is divided using electrocautery or scissors from inside the joint. This allows the patella to sit more centrally in the trochlear groove. The procedure takes 15–20 minutes and is often performed as part of other knee surgery.
Lateral release is considered for lateral patellar tilt or compression syndrome causing anterior knee pain, when conservative treatment has failed. It is less commonly performed in isolation now and is more often combined with medial-side procedures.
Physiotherapy (VMO strengthening, patellar taping), orthotics, and activity modification. These are effective for most patients.
X-rays (skyline view) and MRI. Evidence of lateral patellar tilt is needed.
Reduction of anterior knee pain from lateral patellar compression in well-selected patients.
Bleeding into the knee joint. The most common complication — approximately 10-20%.
Lateral release alone may not resolve all anterior knee pain.
Excessive release may cause the patella to dislocate medially.
Over the release site.
Joint infection.
Chronic pain syndrome.
General, spinal, or local anaesthesia.
Weight-bearing immediately. Compression bandage for haemarthrosis prevention. Physiotherapy for quadriceps and patellar tracking. Return to activity at four to six weeks.
Review at two weeks. Further as needed.
It was historically overused as a standalone procedure. Current evidence supports it mainly as part of a comprehensive patellar realignment rather than in isolation.