Lateral release for patellofemoral arthritis

Purpose: To determine the outcome of treatment of patients with symptomatic patellofemoral osteoarthritis by closed lateral patellar retinacular release. Type of Study: Retrospective study. Methods: Fifty patients who underwent 53 lateral retinacular release procedures between 1995 and 1999 for the treatment of symptomatic patellofemoral arthritis were assessed by questionnaire comprising the Oxford knee score, a visual analogue scale (VAS, 0-10) for pain, and questions relating to level of patient satisfaction. Patients were included in this study whether or not tibiofemoral arthritis was present, but lateral release was performed only in those for whom the anterior knee pain of patellofemoral arthritis appeared to predominate. Results: The average patient age was 53 years (range, 27 to 79 years). There were 14 men (28%) and 36 women (72%). Follow-up was a mean of 31 months (range, 12 to 65 months). Four patients underwent total knee replacement at 7, 14, 16, and 18 months after lateral release for recurrence of symptoms. In the remaining 49 knees, mean pain VAS was 3.8 +/- 2.8. In 39 knees (80%), patients judged that they had experienced a reduction in pain compared with their preoperative state (2 were pain free), 8 (16%) were unchanged, and 2 (4%) were worse. The average Oxford knee score was 27 (range, 12-48). At follow-up, 33% of patients were very satisfied, 26% satisfied, and 41% dissatisfied with their knee. The presence of tibiofemoral disease did not affect any of the outcome measures. Two patients developed superficial infections of the arthroscopic port sites. There were no cases of hemarthrosis. Conclusions: Arthroscopic lateral release is effective in reducing the pain of symptomatic patellofemoral osteoarthritis and gives reasonable rates of patient satisfaction irrespective of the presence of tibiofemoral arthritis.