Arthroscopic lateral retinacular release using a modified superomedial portal, electrosurgery, and postoperative...

A technique for utilizing a modified superomedial portal, 6 cm proximal to and in line with the medial edge of the patella, is described for observing patellar tracking and performing a lateral retinacular release. The lateral release is performed without tourniquet using electrosurgery, and the knee is positioned in 90 degree flexion for two days postoperatively. The technique was used in 53 patients with lateral patellar and soft tissue tenderness and pain, 31 of whom had lateral patellar subluxation documented on 45 degrees Merchant x-ray views. Patients with a history of dislocation or a Q angle of more than 18 degrees were excluded. Conservative treatment averaged seven months pre-operatively. Results in 75% of the patients (37 knees) were rated good or excellent at an average follow-up of 20 months. One postoperative hemarthrosis occurred. This technique facilitates patellar evaluation and lateral release under direct vision using the same portal, as well as permitting early range of motion postoperatively.