Isolated lateral release or lateral lengthening for non-instability indications: A systematic review.

Abstract

Isolated lateral release (LR) and lateral lengthening (LL) may have a role in the management of knee pain without instability, but these indications have not been clearly defined. This study sought to evaluate the use of isolated lateral release and lateral lengthening for non-instability indications of the knee. PubMed, Embase, and Web of Science were queried for terms related to lateral release and lateral lengthening of the knee. Included studies investigated isolated LR or LL as an intervention for non-patellofemoral instability indications of the knee that were published in English and in peer-reviewed journals. Studies were excluded if they investigated LR or LL for patellofemoral instability or during total knee arthroplasty, published before 2000, systematic reviews, biomechanical studies, and case reports. Surgery indications, patient demographics, patient-reported outcome measures (PROMs), complications and subsequent surgeries, were collected. Seven studies with 404 patients were included, 4 of which investigated LR/LL for lateral patellar compression syndrome (LPCS), 1 for anterior knee pain, 1 for patellofemoral arthritis, and 1 for patellofemoral arthrofibrosis following anterior cruciate ligament reconstruction. All seven studies reported significant improvements in PROMs and clinical outcomes, regardless of indication. The most common complications were postoperative hemarthrosis, medial patellar instability, and fibrosis. Isolated LR and LL are viable options for the management of LPCS, anterior knee pain, and postoperative patellofemoral arthrofibrosis that lead to improvements in PROMs. Medial patellar instability is a feared complication of LR/LL but appears to be more likely in patients undergoing LR. Systematic Review; LOE IV.