Full arthroscopic lateral retinacular release with hook knife and quadriceps pressure-pull test: long-term follow-up

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dc.authoridOzcan, Mert/0000-0002-2009-1881
dc.contributor.authorCalpur, OU
dc.contributor.authorOzcan, M
dc.contributor.authorGurbuz, H
dc.contributor.authorTuran, F
dc.date.accessioned2024-06-12T10:51:53Z
dc.date.available2024-06-12T10:51:53Z
dc.date.issued2005
dc.departmentTrakya Üniversitesien_US
dc.description.abstractThe most important causes of anterior knee pain include patellofemoral malalignment which causes patella - condyle contact anomalies at the patellofemoral joint, excessive patellar lateral pressure increase, trauma and overuse. In this article, besides presentation of late clinical results of 169 lateral retinacular release cases which were surgically treated between January 1995 and December 2002 with the help of a hook knife from the anterolateral portal due to lateral compression syndrome and patellar maltracking, we also described quadriceps tendon pressure-pull test which strongly indicates patellofemoral pain during physical examination of a patient with anterior knee pain. In addition to radiological patellofemoral imaging methods, we describe dynamic arthroscopic patellofemoral joint examination which is applied perarthroscopically to all of our surgically treated patients. We divided the patients into two groups: group 1 was the younger group with age 16 - 40 years; group 2 was the older group with age > 41 years. Preoperative mean Lysholm scores for group I was 67.6 and 98.6, postoperatively, whereas it was 62.3 preoperatively and 91.4 postoperatively in group 2. This improvement of Lysholm scores postoperatively was statistically significant for each of the two groups ( p= 0.001). For group 1 preoperative IKDC scores were A in 8 patients, B in 61 patients and C in 11 patients, whereas it was A in 78 patients and B in 2 patients postoperatively. For group 2 preoperative IKDC scores were A in 2 patients, B in 43 patients, C in 36 patients and D in 8 patients, whereas it was A in 78 patients and B in 11 patients. This improvement of IKDC scores postoperatively was also statistically significant for each of the two groups ( p= 0.001). Preoperative and postoperative congruens angles of all patients were also measured. Preoperative mean congruens angle was + 16.4 in group 1 while mean congruent angle was - 7.1 postoperatively. For group 2 preoperative mean congruens angle was + 18.7 preoperatively and - 6.9 postoperatively. This improvement was statistically significant for each of the two groups ( p= 0.001). The overall number of patellar lateral compression syndrome cases were 51 ( 24 in group 1, 27 in group 2), patellar lateralization cases were 64 ( 28 in group 1, 36 in group 2) and patellar subluxation cases were 54 ( 28 in group 1, 26 in group 2). At the evaluation of arthroscopic lateral patellar facet and lateral femoral condylar chondral pathologies, we statistically showed that patellar chondral pathologies were more severe than the femoral chondral pathologies ( p= 0.001). In our opinion, the severity of patellar lateral facet chondral lesions, although it has a thicker layer of cartilage, is due to distribution of load to a larger contact area of lateral femoral condyle [ 1, 2]. Statistically increasing severity of femoral ( Kendall's tau-b: 0.248, p= 0.001) and patellar chondral lesions ( Kendall's tau-b: 0.444, p= 0.0001) with age is compatible with our arthroscopic and clinical observations. The most important complication seen in our cases was fibrosis at the site of lateral release, seen in three patients. They were healed without any sequela with local corticosteroid injection into the fibrosis tissue. We did not see any hemarthrosis or haematoma as a complication.en_US
dc.identifier.doi10.1007/s00167-003-0474-4
dc.identifier.endpage230en_US
dc.identifier.issn0942-2056
dc.identifier.issue3en_US
dc.identifier.pmid15067501en_US
dc.identifier.scopus2-s2.0-17644391759en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage222en_US
dc.identifier.urihttps://doi.org/10.1007/s00167-003-0474-4
dc.identifier.urihttps://hdl.handle.net/20.500.14551/18506
dc.identifier.volume13en_US
dc.identifier.wosWOS:000228548700014en_US
dc.identifier.wosqualityQ2en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherSpringeren_US
dc.relation.ispartofKnee Surgery Sports Traumatology Arthroscopyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectAnterior Knee Painen_US
dc.subjectArthroscopicen_US
dc.subjectPatellar Malalignmenten_US
dc.subjectLateral Retinacular Releaseen_US
dc.subjectPatellofemoral Jointen_US
dc.subjectPatellar Instabilityen_US
dc.subjectComputed-Tomographyen_US
dc.subjectPainen_US
dc.subjectMalalignmenten_US
dc.subjectDisordersen_US
dc.subjectContractionen_US
dc.subjectSubluxationen_US
dc.subjectTrackingen_US
dc.subjectHolmiumen_US
dc.titleFull arthroscopic lateral retinacular release with hook knife and quadriceps pressure-pull test: long-term follow-upen_US
dc.typeArticleen_US

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