Lateral retinacular release as a function of femoral component rotation in total knee arthroplasty

A consensus exists in the orthopaedic community that proper rotational placement of components may reduce the need for lateral release. This study compares the rates and results of lateral release before and after femoral component placement was defined by the transepicondylar axis (TEA). Between 1990 and 1991, 104 primary total knee arthroplasties (TKA) were reviewed during which equal amounts of bone from the posterior femoral condyles were removed. In this group, the lateral release incidence was 24% for varus deformities and 33% for valgus deformities. When the femoral component was externally rotated approximating the TEA, a review of 246 primary TKAs performed between 1998 and 1999 showed lateral release rates of 7% in varus deformities and 29% in valgus deformities. This study documents the statistically significant decline in the lateral release rate with external rotation of the femoral component during TKA in varus deformities (P<.0001), and a decreasing trend in valgus knees (P =.09).