The Study Of Arthroscopic Lateral Release For The Treatment Of Patellar Instability

Objective: The operation and clinical results of arthroscopic lateral release for thetreatment of patellar were investigated in this study.Methods: From September2009to September2011, thirty-five knees of twenty-ninepatients were treated with arthroscopic lateral release for patellar instability. Theelectrocautery device was used to sequentially divide, from inferior to superior, the lateralfat pad, the scarred tissue, and the vastus lateralis. The vastus lateralis was dissected fromthe insertion on the superior pole of the patella and released proximally20-25mm along thelateral border of the quadriceps tendon[1]. Postoperative dirigation were undergone. Paired Ttests (IBM SPSS Statistics19.0)were used to assess the preoperative to postoperativechanges for3variables: Lysholm score、Congruence angle and Lateral Patellofemoral angle;significance was set at P<0.05.Results: Twenty-seven patients (93%) were satisfied with clinical results of arthroscopiclateral release for the treatment of patellar. All patients were preoperative found positivepatellar apprehension test, negative patellar tilt test, positive patellar grind test, limitedmedial patellar glide test. During postoperative physical exam, Thirty-four knees(97%)were rated positive patellar tilt test, one negative; Thirty-one knees(88%) were ratednegative patellar apprehension test, four positive; Thirty-two knees(91%) were ratednegative patellar grind test, three positive; Thirty-four knees(97%) were rated Ⅱ＋medial patellar glide test, one Ⅰ＋medial patellar glide test. There was a statistically significantimprovement in the Lysholm score from30.2±8.5before surgery to76.5±10.9after surgery(P<0.01), in the congruence angle from17.6°±4.9°before surgery to-7.8°±4.9°aftersurgery (P<0.01) and in the lateral patellofemoral angle from-7.1°±3.1°before surgery to7.4°±2.4°after surgery (P<0.01).Conclusion: It is Arthroscopic Lateral Release that is a excellent surgical procedure forthe Treatment of Patellar Instability. All patients have improved in subjective clinicalsymptom, objective physical exam and image examination. It has the advantages ofminimal trauma, providing a cosmetically acceptable outcome, dealing simultaneously withother intra-articular soft-tissue pathological changes and quickly recovery. Overall, it isworth further popularizing the application of arthroscopic lateral release for the treatment ofpatellar instability.