LATERAL RELEASE AND MEDIAL IMBRICATION
A Treatment for Patella Alignment Disorders
Surgeons use this procedure to loosen or tighten ligaments on either side of the patella (kneecap) to improve the movement of the patella in patients suffering from patellar tracking disorder or recurrent patella dislocation. Surgeons utilize an arthroscope perform this procedure through one or two small incisions near the patella.
Patellar Tracking Disorder
Patellar tracking disorder occurs when the kneecap (patella) shifts out of place as the leg bends or straightens. In most cases, the kneecap shifts too far toward the outside of the leg, although in a few people it shifts toward the inside. Your knee joint acts as a complex hinge that joins the lower leg bones (tibia and fibula) with the thighbone (femur). Tendons and ligaments hold the kneecap in place at the front of the knee joint. The tendons support vertical placement of the kneecap, and the ligaments support the sides of the kneecap. A layer of cartilage lines the underside of the kneecap, helping it glide along the groove at the end of your thighbone. The kneecap can shift or rotate off track if the groove does not stabilize the plane of motion such as with a shallow groove or with damaged cartilage. Loose or too tight ligaments, tendons, and muscles, may also lead to a misaligned kneecap from improper support and tension.
Recurrent Patella Dislocation
The patella being a floating bone bound by ligaments and seated in a bony groove, called the trochlea, can slip out of place and fail to do its job correctly, causing pain or reduced range of motion. Possibly this can happen from just once from trauma, but if the medial patellofemoral ligament (MPFL) is damaged then the Patella can continue to chronically displace. The chronic displacement of the patella is known as a recurrent patella dislocation. Recurrent Patella dislocation is a painful, and frustrating, condition that may require the services of an orthopedic specialist.
Lateral Release and Medial Imbrication
Under anesthesia a surgeon uses an arthroscope to enter the knee cavity and release the outward tension on the patella by partially cutting into the lateral retinaculum, a supporting ligament of the patella, weakening the force pulling it outward so the patella sits further inward pulled by the medial retinaculum. If the patella needs more force to pull it into place the surgeon will use imbrication sutures to tighten the medial retinaculum ligament on the inside of the knee. As time passes the lateral release heals over with scar tissue stabilizing the incision. Recovery takes around six to twelve months for full recovery.