Arthroscopic Lateral Retinacular Release and Modified Goldthwait Technique for Patellar Instability

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomechanical Engineering

Background:

• Patellofemoral (PF) disorders have various surgical treatments, but concerns exist regarding skeletal immaturity and donor-site morbidity.
• Recurrent patellar instability often stems from maltracking, necessitating surgical correction to improve PF mechanics.

Purpose of the Study:

• To describe the arthroscopic lateral retinacular release combined with the modified Goldthwait procedure for treating recurrent patellar instability.
• To detail a functional surgical technique for improving patellofemoral tracking and correcting the Q angle.

Main Methods:

• The modified Goldthwait procedure involves hemi-patellar transfer and medialization.
• This is combined with an arthroscopic lateral retinacular release.
• The technique aims to medialize the PF contact point in flexion and correct maltracking.

Main Results:

• The combined procedure effectively medializes the patellofemoral contact point during flexion.
• It corrects patellar maltracking, thereby preventing recurrent patellar dislocations.
• This functional approach addresses lateralizing forces on the patella by correcting the Q angle.

Conclusions:

• Arthroscopic lateral retinacular release combined with the modified Goldthwait procedure is an effective surgical option for recurrent patellar instability.
• This technique is particularly useful in pediatric patients due to its accommodation of tibial tubercle and physeal immaturity.
• The procedure successfully improves patellofemoral tracking and reduces the risk of recurrent dislocations.