For a long time lateral release (LR) was performed as a standard procedure both, for patellofemoral pain syndrome (PFPS) and patellofemoral instability (PFI). However, recent biomechanical studies have shown that LR is not useful for decreasing the lateral force onto the patella, but is increasing not only medial but also lateral PFI. Furthermore, pain on palpation over the lateral patellofemoral joint space can result in patients treated with extensive LR. We postulate that in case of persistent PFI or PFPS after failed LR the reconstruction of the lateral retinaculum as an addition of the reconstruction of the medial patellofemoral ligament (MPFL) is necessary in terms of decreasing medial PFI as well as lateral pain. In between 03/07 and 04/09 we have seen a total of 25 patients (20 f, 5 m) with persistent PFI and palpatory pain over the lateral retinaculum due to unsuccessful treatment of PFI with a LR. These patients have undergone revision surgery with an anatomical reconstruction of the released lateral retinaculum in combination with a reconstruction of the medial patellofemoral ligament (MPFL) in an aperture-technique using the gracilis tendon. The average age at time of operation was 26.2 ± 9.8 years. Preoperatively, as well as 6 weeks, 3 months, 6 months, and 12 months postoperatively, clinical examinations were performed and subjective as well as objective scores (Kujala-, Tegner-, IKDC-score) were evaluated. Regarding radiological parameters measurement of patellar tilt and shift was carried out on axial radiographs before and after the operation.Objectives
Materials and Methods
