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Related Experiment Video

Updated: Apr 5, 2026

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Deep Transverse Lateral Retinaculum Reconstruction for Medial Patellar Instability.

Vicente Sanchis-Alfonso1, Erik Montesinos-Berry2, Joan Carles Monllau3

  • 1Department of Orthopaedic Surgery, Hospital 9 de Octubre, Valencia, Spain.

Arthroscopy Techniques
|August 11, 2015
PubMed
Summary

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Medial patellar instability after lateral retinaculum release can be disabling. Reverse McConnell taping offers relief, and surgical reconstruction of the lateral retinaculum may be necessary for persistent cases.

Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Biomechanics

Background:

  • Medial patellar instability is a potential complication following extensive lateral retinaculum release surgery.
  • This complication is often underdiagnosed and requires a high index of suspicion for accurate diagnosis.
  • Patients typically present with new, severe pain and instability distinct from preoperative symptoms.

Purpose of the Study:

  • To describe a diagnostic approach for medial patellar instability after lateral retinaculum release.
  • To present a surgical technique for lateral retinaculum reconstruction to address this specific complication.
  • To evaluate the efficacy of non-operative and operative management strategies.

Main Methods:

  • Clinical assessment including a high index of suspicion for medial patellar instability.

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  • Diagnostic use of "reverse" McConnell taping for symptom relief.
  • Confirmation with stress radiographs or stress axial computed tomography (CT) scans to identify medial patellar displacement.
  • Surgical technique involving reconstruction of the deep transverse layer of the lateral retinaculum using an iliotibial band autograft.
  • Main Results:

    • "Reverse" McConnell taping provided significant pain relief in all affected patients.
    • Objective pathological medial patellar displacement was confirmed via stress imaging in cases with symptomatic improvement.
    • The described surgical technique successfully reconstructed the lateral retinaculum.

    Conclusions:

    • Medial patellar instability is a significant complication of lateral retinaculum release that warrants specific diagnostic consideration.
    • Non-operative management with "reverse" McConnell taping can be effective for symptom management.
    • Surgical reconstruction of the lateral retinaculum using an iliotibial band graft is a viable option for persistent instability.