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A Simple, Stepwise, Outside-in Technique for Lateral Retinacular Release for Management of Patellar Maltracking During Total Knee Arthroplasty

March 01, 2020

Contributors: Rajesh N Maniar, MD; Adit Rajesh Maniar, MBBS, MS

2020 HONORABLE MENTION Lateral retinacular release is necessary to correct patellar maltracking during total knee arthroplasty. The current inside-out technique involves cutting the synovial layer and exposing the joint to the subcutaneous layer and is associated with a risk of complications. This video describes an outside-in technique that preserves the synovial cover, protecting the joint and metal underneath. Patellar maltracking is graded, after which an outside-in technique is performed in a titrated, stepwise manner if required. Step one involves release from the middle patellar level to the upper border of tibia. Step two involves proximal extension of the release to the superior patellar border. Step three involves additional release proximally, achieving complete release of the lateral retinaculum. This technique is easy to perform, preserves the synovium, and can be used with all types of implants, resulting in excellent outcomes.

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