The Role of Lateral Retinacular Release in Preventing Patellofemoral Malalignment in Double-Bundle Anterior Cruciate Ligament Reconstruction: A Randomized Controlled Trial
- Author:
Ludwig Andre PONTOH
1
;
Ismail Hadisoebroto DILOGO
;
Erica KHOLINNE
;
Jessica FIOLIN
;
Toto Suryo EFAR
Author Information
- Publication Type:Original Article
- From:Clinics in Orthopedic Surgery 2022;14(3):393-400
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background:Loss of internal rotation stability is the major cause of pain after an anterior cruciate ligament reconstruction (ACLR).Many authors described measures to treat this problem to no avail. This is the first study evaluating the role of lateral release with double-bundle ACLR to prevent patellofemoral malalignment after ACLR.
Methods:A total of 100 patients were included in this prospective study between January 2018 and December 2019. We compared single-bundle ACLR (group 1, n = 30), double-bundle ACLR (group 2, n = 30), and double-bundle ACLR with lateral release (group 3, n = 40). Clinical outcome was evaluated with the Kujala score while radiological outcome was evaluated using the tibial tubercle-trochlear groove (TTTG) distance in magnetic resonance imaging. The preoperative and postoperative values were compared.
Results:At the final follow-up of 6–18 months, group 3 showed the lowest TTTG value (6.7 ± 4.69) compared to group 2 (9.1 ± 4.83) and group 1 (11.74 ± 1.76) (p = 0.03). The Kujala score was significantly improved in all groups: from 68.83 to 89.90 in group 1, from 70.02 to 91.23 in group 2, and from 69.71 to 95.05 in group 3 (p = 0.03). Group 3 showed the most superior improvement in the Kujala score (25.34) compare to group 1 (21.07) and group 3 (21.21) (p = 0.012).
Conclusions:Concomitant lateral retinacular release significantly improved the Kujala score. It may serve as a valuable option to overcome patellofemoral pain syndrome in ACLR.
