Long-Term Outcomes of Arthroscopic Lateral Retinacular Release Combined with Medial Reefing for Proximal Realignment of the Patella in Patients with Acute or Subacute First-Time Patellar Dislocation

Background: We have efficiently combined arthroscopic lateral retinacular release with medial reefing for proximal realignment of the patella in patients with patellar dislocation. We therefore conducted this study to assess long-term outcomes of our technique. Methods: The current study was conducted in a total of 67 patients who were surgically treated at our medical institution between February 2012 and March 2024. The patients were evaluated for whether there were significant differences in the patellar tilt angle, congruence angle, tibial tubercle-trochlear groove distance (TT-TG), Insall-Salvati index, Lysholm knee scores and Kujala score between preoperatively and postoperatively. Results: A total of 47 patients (n = 47; 25 men and 22 women) (48 knees) were finally included in the current study; their mean age was 30.7 ± 11.3 (range, 15-63) years old and they were followed up during a mean period of 36.9 ± 25.5 (range, 24-120) months. Preoperatively, the Q-angle and sulcus angle were measured as 14.0° ± 2.7° and 134.4° ± 1.5°, respectively. Preoperatively, the patellar tilt angle, congruence angle, Insall-Salvati index, TT-TG distance, Lysholm knee scores and Kujala scores were measured as 21.6° ± 4.7°, 16.9° ± 14.2°, 0.9 ± 0.1, 17.5 ± 1.9 mm, 45.7 ± 6.4 points and 58.7 ± 8.7, respectively. Postoperatively, these measurements were 10.9° ± 1.4°, 1.0° ± 3.7°, 1.1 ± 0.1, 12.9 ± 1.6 mm, 87.9 ± 4.3 points and 89.7 ± 3.7 points in the corresponding order. These difference reached statistical significance (p < 0.05). Postoperatively, there was only one case (2.1%) of recurrence at postoperative 2 months, but this was corrected by revision arthroscopic repair. Moreover, there was one case of hematoma, but this was managed with aspiration. Furthermore, there were two cases of a loss of flexion of < 135°. Two months later, this was treated with manipulation. But there were no other postoperative complications such as patellar fracture or infection. Conclusion: Arthroscopic lateral retinacular release combined with medial reefing for proximal realignment of the patella is an effective, safe modality in patients with acute or subacute patellar dislocation.