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Indications for lateral retinacular release in total knee replacement
Michael J Archibeck1, David Camarata, James Trauger
1New Mexico Center for Joint Replacement Surgery, Albuquerque, USA. archibeckmj@ortholink.net
Clinical Orthopaedics and Related Research
|September 11, 2003
Summary
The towel clip test is more reliable than the rule of no thumb test for determining lateral retinacular release during total knee replacement surgery. The rule of no thumb test often leads to unnecessary procedures.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
Background:
- Lateral retinacular release is a surgical technique used in total knee replacement.
- Accurate methods are needed to determine the necessity of this procedure.
Purpose of the Study:
- To compare the efficacy of the towel clip test versus the rule of no thumb test in identifying the need for lateral retinacular release during primary total knee replacement.
Main Methods:
- A prospective study involving 200 primary total knee replacements.
- Comparison of positive results from the towel clip test and the rule of no thumb test.
- Radiographic evaluation at 6 months postoperatively for patellar alignment.
Main Results:
- The towel clip test was positive in 6.5% of knees, while the rule of no thumb test was positive in 39%.
- No patellar tilt, subluxation, or dislocation was observed in knees where release was based on a positive towel clip test.
- The rule of no thumb test resulted in a 32.5% false positive rate for the need for lateral release.
Conclusions:
- The towel clip test is a more accurate and reliable method for determining the need for lateral retinacular release in total knee replacement.
- The rule of no thumb test overestimates the requirement for lateral retinacular release, leading to potentially unnecessary interventions.