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When to Add Lateral Soft Tissue Balancing?
Sports Med Arthrosc Rev. 2019 Dec; 27(4):e25-e31.SM

Abstract

Lateral patellofemoral (PF) soft tissue abnormalities range from excessive lateral PF tightness (lateral patellar compression syndrome, lateral patellar instability and arthritis), to excessive laxity (iatrogenic lateral PF soft tissue insufficiency postlateral release). The lateral soft tissue complex is composed of the iliotibial band extension to the patella, the vastus lateralis tendon, the lateral PF ligament, lateral patellotibial ligament, and lateral patellomeniscal ligament, with intimate connections between those structures. To identify lateral retinaculum tightness or insufficiency the most important tests are the patellar glide test and patellar tilt test. Imaging aids in that evaluation relying mostly on the patella position assessed by radiographs, computed tomography, and magnetic resonance imaging with referencing to the posterior femoral condyles. Lateral retinaculum lengthening (preferred) or release may be added when there is excessive lateral retinaculum tightness. A lengthening may be performed using a minimally invasive approach without compromising the lateral patella restraint. Lateral retinaculum repair or reconstruction is indicated when there is lateral retinaculum insufficiency. Lateral retinaculum surgery to balance the medial/lateral soft tissue restraints, improves patellar positioning and clinical results.

Authors+Show Affiliations

Department of Orthopaedic Surgery, William Beaumont Hospital, Royal Oak, MI.Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL.Brigham and Woman's Hospital, Harvard Medical School, Boston, MA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31688535

Citation

Hinckel, Betina B., et al. "When to Add Lateral Soft Tissue Balancing?" Sports Medicine and Arthroscopy Review, vol. 27, no. 4, 2019, pp. e25-e31.
Hinckel BB, Yanke AB, Lattermann C. When to Add Lateral Soft Tissue Balancing? Sports Med Arthrosc Rev. 2019;27(4):e25-e31.
Hinckel, B. B., Yanke, A. B., & Lattermann, C. (2019). When to Add Lateral Soft Tissue Balancing? Sports Medicine and Arthroscopy Review, 27(4), e25-e31. https://doi.org/10.1097/JSA.0000000000000268
Hinckel BB, Yanke AB, Lattermann C. When to Add Lateral Soft Tissue Balancing. Sports Med Arthrosc Rev. 2019;27(4):e25-e31. PubMed PMID: 31688535.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - When to Add Lateral Soft Tissue Balancing? AU - Hinckel,Betina B, AU - Yanke,Adam B, AU - Lattermann,Christian, PY - 2019/11/6/entrez PY - 2019/11/7/pubmed PY - 2019/11/7/medline SP - e25 EP - e31 JF - Sports medicine and arthroscopy review JO - Sports Med Arthrosc Rev VL - 27 IS - 4 N2 - Lateral patellofemoral (PF) soft tissue abnormalities range from excessive lateral PF tightness (lateral patellar compression syndrome, lateral patellar instability and arthritis), to excessive laxity (iatrogenic lateral PF soft tissue insufficiency postlateral release). The lateral soft tissue complex is composed of the iliotibial band extension to the patella, the vastus lateralis tendon, the lateral PF ligament, lateral patellotibial ligament, and lateral patellomeniscal ligament, with intimate connections between those structures. To identify lateral retinaculum tightness or insufficiency the most important tests are the patellar glide test and patellar tilt test. Imaging aids in that evaluation relying mostly on the patella position assessed by radiographs, computed tomography, and magnetic resonance imaging with referencing to the posterior femoral condyles. Lateral retinaculum lengthening (preferred) or release may be added when there is excessive lateral retinaculum tightness. A lengthening may be performed using a minimally invasive approach without compromising the lateral patella restraint. Lateral retinaculum repair or reconstruction is indicated when there is lateral retinaculum insufficiency. Lateral retinaculum surgery to balance the medial/lateral soft tissue restraints, improves patellar positioning and clinical results. SN - 1538-1951 UR - https://www.unboundmedicine.com/medline/citation/31688535/When_to_Add_Lateral_Soft_Tissue_Balancing L2 - http://dx.doi.org/10.1097/JSA.0000000000000268 DB - PRIME DP - Unbound Medicine ER -