Lateral patellofemoral ligament reconstruction to restore functional capacity in patients previously undergoing lateral retinacular release

AIM: To study patient outcomes after surgical correction for iatrogenic patellar instability.METHODS: This retrospective study looked at 17 patients(19 knees) suffering from disabling medial patellar instability following lateral release surgery. All patients underwent lateral patellofemoral ligament(LPFL) reconstruction by a single surgeon. Assessments in all 19 cases included functional outcome scores, range of motion, and assessment for the presence of apprehension sign of the patella to determine if LPFL reconstruction surgery was successful at restoring patellofemoral stability.RESULTS: No patients reported any residual postoperative symptoms of patellar instability. Also no patients demonstrated medial patellar apprehension or examiner induced subluxation with the medial instability test described earlier following LPFL reconstruction. Furthermore, all patients recovered normal range of motion compared to the contralateral limb. For patients with pre and postoperative outcome scores, the mean overall knee injury and osteoarthritis outcome score increased significantly, from 34.39 preoperatively(range: 7.7-70.12) to 69.54 postoperatively(range:26.82-91.46) at final follow-up(P < 0.0001). CONCLUSION: This novel technique for LPFL reconstruction is effective at restoring lateral restraint of the patellofemoral joint and improving joint functionality.