Clinical Outcome of Arthroscopic Lateral Release for Lateral Patellar Compression Syndrome

Objective: In this study, we have evaluated the effects of isolated arthroscopic lateral retinacular release in lateral patellar compression syndrome according to Lysholm Knee Scoring Scale. Methods: a prospective case series study of 48 patients who suffered Lateral patellar compression syndrome who were diagnosed by clinical examination and confirmed by M.R.I. and failed conservative management and underwent isolated arthroscopic lateral patellar retinaculum. Results: There was significant improvement in Lysholm score, in particular for pain, using stairs and squatting. The procedure had a high mean satisfaction score of 83.15 post operatively which is significant compared to preoperative score which was 51.17 (p<0.001). Conclusion: Isolated patella retinaculum release can be effective for relieving anterior knee pain in isolated lateral patellar compression syndrome without significant instability or mal-alignment.

Open versus arthroscopic release for lateral patellar compression syndrome: a randomized-controlled trial

Introduction Lateral patellar compression syndrome is one of the causes of anterior knee pain in young adults and resulted from tight lateral patellar retinaculum. The aim of our study is to compare between open and arthroscopic release of lateral patellar compression syndrome in relation of functional outcome, time of surgical procedure, length of hospital stays, intraoperative and postoperative complications as bleeding, infection, recurrence, and patellar instability with 2 years of follow-up. Materials and methods 80 patients, age (21–49 years), were divided randomly into 2 groups (A and B). Group A (40 patients) were treated with open release. Group B (40 patients) were treated by arthroscopic release. All these patients are diagnosed as lateral patellar compression syndrome depending on clinical features and MRI. All patients were assessed by Lysholm knee scoring scale before surgery and at periods of 2, 6 weeks, 6, 12, and 24 months after surgery. Results There is significant difference in functional outcome, measured by Lysholm knee scoring scale, between preoperative and postoperative assessment periods in both groups (P < 0.001). There is significantly better functional outcome at 2 years of follow-up with arthroscopic release (P = 0.018). There is no recurrence in both groups, but there were 4 patients develop medial patellar instability in the group of open release. Conclusion Both open and arthroscopic lateral release for patients with isolated lateral patellar compression syndrome can be effective surgical procedures, but arthroscopic release can achieve better functional outcome. Trial registration: NCT, NCT04130412. Retrospectively registered on 3rd of June, 2020 at ClinicalTrials.gov.

Isolated Arthroscopic Lateral Retinacular Release for Lateral Patellar Compression Syndrome

Introduction: Evidence concerning the role of isolated lateral retinacular release (LRR) for lateral patellar compression syndrome (LPCS) dates back at least three decades. Appropriate indications, execution and outcomes still remain unclear and controversial. The present investigation analyzed the midterm result of isolated and arthroscopic LRR for LPCS in a cohort of patients who underwent such procedure at our institution. Material and methods: Patients undergoing isolated arthroscopic LRR for LPCS were identified retrospectively from our electronic database. All procedures were performed by two experienced surgeons. Patients with bony and/or soft tissues abnormalities, patellofemoral instability, moderate to severe chondral damage were not included. Patients with previous surgeries were not included, as were those who underwent combined interventions. Clinical scores and complications were recorded. Results: 31 patients were recruited in the present investigation. The mean follow-up was 86.0 ± 22.8 months. The mean age of the patients at the index operation was 34.2 ± 13.1 years. A total 55% (17 of 31) were women, and 58% (18 of 31) had involved the right knee. The mean hospitalization length was 3.5 ± 1.4 days. At a mean follow-up of 86.0 ± 22.8 months, the numeric rating scale (NRS) was 1.2 ± 0.8, the Kujala score was 91.3 ± 11.3, the Lysholm score was 93.1 ± 15.0, and the Tegner score was 5.0 ± 1.8. At the latest follow-up, 9 of 31 (29.0%) of patients experienced compilations. One patient (3.2%) had a post-operative hemarthrosis which was managed conservatively. Six patients (19.4%) reported a persistent sensation of instability, without signs of patellar dislocation or subluxation. One patient underwent an arthroscopic meniscectomy, and another patient an anterior cruciate ligament (ACL) reconstruction. Conclusion: isolated arthroscopic lateral retinacular release for lateral patellar compression syndrome is feasible and effective, achieving satisfying results at more than seven years following the procedure.

Use of hyaluronic acid injection after arthroscopic release in lateral patellar compression syndrome with degenerative cartilage changes: randomized control trial

Background Degenerative cartilage changes can be seen, in cases of lateral patellar compression syndrome, involving the patellofemoral joint. Hyaluronic acid is a natural component of the synovial fluid and responsible for its elastic features and function of articular surfaces. The aim of this study is to show the effect of intra-articular injection of Hyaluronic acid, after arthroscopic lateral release in lateral patellar compression syndrome, on the functional outcome and knee pain in those patients with degenerative cartilage changes. Method Ninety patients age (30–50) years with lateral patellar compression syndrome and degenerative cartilage changes were divided randomly into 2 groups. Group A was treated by arthroscopic lateral release and received intraarticular injection of Hyaluronic acid 2 weeks after surgery. Group B was treated by arthroscopic lateral release only. Both groups were assessed by Kujala score and visual analogue scale for knee pain preoperatively and re-assessed postoperatively at 3 months, 6 months, 12 months and 24 months. Results There was significant improvement in Kujala score and Visual analogue scale post-operatively in both groups (P-value< 0.001) with better improvement in Kujala score in group A after intra-articular injection of Hyaluronic acid up to 2 year of follow up (P-value = 0.006) as well as better improvement in visual analogue score at 6 months post-operatively (P-value = 0.035). Conclusion Intra-articular injection of Hyaluronic acid after arthroscopic release, in patients with lateral patellar compression syndrome and degenerative cartilage changes, can result in better improvement of knee pain and functional outcome up to 2 years of follow up. Trial registration NCT, NCT04134611. Registered 18 October 2019 -Retrospectively registered.

Open Versus Arthroscopic Release for Lateral Patellar Compression Syndrome: A Randomized Controlled Trial

Background: Lateral patellar compression syndrome is one of the causes of anterior knee pain in young adults and resulted from tight lateral patellar retinaculum, which can be treated by surgical release of tight retinaculum after failure of conservative measures. Surgical release can be done by open or arthroscopic procedures. There was no randomized control trial to compare between these two procedures in considering of functional outcome and complications. The aim of our study is to compare between open and arthroscopic release of lateral patellar compression syndrome in relation of functional outcome, time of surgical procedure, length of hospital stays, intraoperative and postoperative complications as bleeding, infection, recurrence and patellar instability with 2 years of follow up. Methods: 80 patients, age (21-49 years), were divided randomly into 2 groups (A and B). Group A (40 patients) were treated with open release after diagnostic arthroscopy. Group B (40 patients) were treated by arthroscopic release. All these patients are diagnosed as lateral patellar compression syndrome depending on clinical features, MRI and diagnostic arthroscopy and they had failure of conservative measures of quadriceps strengthening and analgesics for 6 months. All patients were assessed by Lysholm knee scoring scale before surgery and at periods of 2 weeks, 6 weeks, 6 months, 12 months and 24 months after surgery. Results: There is significant difference in functional outcome, measured by Lysholm knee scoring scale, between preoperative and postoperative assessment periods in both groups (P<0.001). There is significantly better functional outcome at 2 years of follow up with the arthroscopic release (P=0.018). There is no recurrence in both groups, but there were 4 patients develop medial patellar instability in the group that was treated by open release. There are 2 patients develop hemarthrosis in arthroscopic group and one patient develop superficial wound infection in the group of open release. There is no significant difference in the postoperative complications between two groups. Conclusion: Both open and arthroscopic lateral release for patients with lateral patellar compression syndrome (without instability, limb malalignment or dysplasia) are effective surgical procedures but arthroscopic release can achieve better functional outcome than open release with less risk of development of post-operative patellar instability.Trial registration: NCT, NCT04130412. Registered 15 October 2019 -Retrospectively registered, https://www.clinicaltrials.gov/NCT04130412

Open Versus Arthroscopic Release for Lateral Patellar Compression Syndrome: A Randomized Control Trial

Background: Lateral patellar compression syndrome is one of the causes of anterior knee pain in young adults and resulted from tight lateral patellar retinaculum, which can be treated by surgical release of tight retinaculum after failure of conservative measures. Surgical release can be done by open or arthroscopic procedures. There was no randomized control trial to compare between these two procedures in considering of functional outcome and complications. The aim of our study is to compare between open and arthroscopic release of lateral patellar compression syndrome in relation of functional outcome, time of surgical procedure, length of hospital stays, intraoperative and postoperative complications as bleeding, infection, recurrence and patellar instability with 2 years of follow up. Methods: 80 patients, age (21-49 years), were divided randomly into 2 groups (A and B). Group A (40 patients) were treated with open release after diagnostic arthroscopy. Group B (40 patients) were treated by arthroscopic release. All these patients are diagnosed as lateral patellar compression syndrome depending on clinical features, MRI and diagnostic arthroscopy and they had failure of conservative measures of quadriceps strengthening and analgesics for 6 months. All patients were assessed by Lysholm knee scoring scale before surgery and at periods of 2 weeks, 6 weeks, 6 months, 12 months and 24 months after surgery.Results: There is significant difference in functional outcome, measured by Lysholm knee scoring scale, between preoperative and postoperative assessment periods in both groups (P<0.001). There is significantly better functional outcome at 2 years of follow up with the arthroscopic release (P=0.018). There is no recurrence in both groups, but there were 4 patients develop medial patellar instability in the group that was treated by open release. There are 2 patients develop hemarthrosis in arthroscopic group and one patient develop superficial wound infection in the group of open release. There is no significant difference in the postoperative complications between two groups.Conclusion: Both open and arthroscopic lateral release for patients with lateral patellar compression syndrome (without instability, limb malalignment or dysplasia) are effective surgical procedures but arthroscopic release can achieve better functional outcome than open release with less risk of development of post-operative patellar instability.Trial registration: NCT, NCT04130412. Registered 15 October 2019 -Retrospectively registered, https://www.clinicaltrials.gov/NCT04130412

Use of Hyaluronic Acid Injection after Arthroscopic Release in Lateral Patellar Compression Syndrome with Degenerative Cartilage Changes: Randomized Control Trial

BackgroundDegenerative cartilage changes can be seen, in cases of lateral patellar compression syndrome, involving the patellofemoral joint. Hyaluronic acid is a natural component of the synovial fluid and responsible for its elastic features and function of articular surfaces. The aim of this study is to show the effect of intra-articular injection of Hyaluronic acid, after arthroscopic lateral release in lateral patellar compression syndrome, on the functional outcome and knee pain in those patients with degenerative cartilage changes. MethodNinety patients age (30-50) years with lateral patellar compression syndrome and degenerative cartilage changes were divided randomly into 2 groups. Group A was treated by arthroscopic lateral release and received intrarticular injection of Hyaluronic acid 2 weeks after surgery. Group B was treated by arthroscopic lateral release only. Both groups were assessed by Kujala score and visual analogue scale for knee pain preoperatively and re-assessed postoperatively at 3 months, 6 months, 12 months and 24 months.ResultsThere was significant improvement in Kujala score and Visual analogue scale post-operatively in both groups (P-value<0.001) with better improvement in Kujala score in group A after intra-articular injection of Hyaluronic acid up to 2 year of follow up (P-value=0.006) as well as better improvement in visual analogue score at 6 months post-operatively (P-value=0.035)ConclusionIntra-articular injection of Hyaluronic acid after arthroscopic release, in patients with lateral patellar compression syndrome and degenerative cartilage changes, can result in better improvement of knee pain and functional outcome up to 2 years of follow up.Trial registration: NCT, NCT04134611. Registered 18 October 2019 -Retrospectively registered, https://www.clinicaltrials.gov/NCT04134611