Postoperative patellar complications with or without lateral release during total knee arthroplasty

Between 1975 and 1984, 84 knees in which an intraoperative lateral release had been performed with total knee arthroplasty (TKA) were compared with 471 knees that, having sufficient patellar tracking at the time of surgery, had not required a lateral release. The lateral superior geniculate artery was routinely sacrificed in all knees in which a lateral release was necessary. The results showed no complications associated with a possible loss of blood supply secondary to the lateral release. No increased evidence of osteonecrosis, patellar bone-cement radiolucency, or patellar fracture was discovered. Clinically, there was no difference in pain, ambulation, or range of motion. Seventeen patellar fractures (3.6%) were observed in patients for whom a lateral release had not been performed, yet only one patellar fracture (1.5%) was encountered among the patients who had required a lateral release. In TKA, lateral release was associated with a relatively high degree of patellar tilting.