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Open lateral patellar retinacular lengthening versus open retinacular release in lateral patellar hypercompression syndrome: a prospective double-blinded comparative study on complications and outcome.
[trochlear dysplasia]
To
compare
complication
rates
and
outcome
of
open
lateral
retinacular
(
LR
)
lengthening
and
open
LR
release
in
the
treatment
of
lateral
patellar
hypercompression
syndrome
(
LPHS
)
.
In
a
prospective
double
-blinded
study
,
28
patients
(
mean
age
,
48
years
;
21
women
and
7
men
)
received
either
LR
release
(
14
patients
)
or
LR
lengthening
(
14
patients
)
in
alternating
fashion
over
the
same
lateral
parapatellar
skin
incision
for
LPHS
(
blinding
of
patients
to
surgical
procedure
[
i
.
e
.
,
single
blinding
]
)
.
Strict
inclusion
criteria
(
retinacular
pain
,
tight
retinaculum
,
decreased
patellar
mobility
)
were
used
to
exclude
other
reasons
for
anterior
knee
pain
(
patellar
instability
,
leg
malalignment
or
maltorsion
,
trochlear
dysplasia
,
patella
alta
)
.
The
surgeon
and
postsurgical
rehabilitation
were
the
same
.
Preoperatively
and
at
3
,
6
,
12
,
and
24
months
postoperatively
,
complications
,
muscle
atrophy
,
and
Kujala
patellofemoral
outcome
score
were
documented
by
examiners
blinded
to
the
surgical
procedure
(
double
blinding
)
.
All
patients
completed
2
years
of
follow-up
.
The
results
of
2
years
of
follow-up
showed
that
recurrence
of
LPHS
,
as
indicated
by
the
patellar
tilt
test
and
decreased
medial
patellar
glide
test
,
developed
in
2
cases
after
LR
release
and
1
case
after
LR
lengthening
(
P
>
.
999
)
.
Medial
patellar
subluxation
,
as
indicated
by
the
gravitation-
subluxation
test
and
increased
medial
patellar
glide
test
,
developed
in
5
cases
after
LR
release
and
no
case
after
LR
lengthening
(
P
=
.
041
)
.
Quadriceps
atrophy
,
as
indicated
by
the
mean
circumference
difference
compared
with
the
healthy
contralateral
side
,
was
significantly
higher
(
P
=
.
001
)
in
the
LR
release
group
(
1
.
8
cm
)
than
in
the
LR
lengthening
group
(
0
.
2
cm
)
.
The
mean
Kujala
score
was
significantly
lower
(
P
=
.
035
)
in
the
LR
release
group
(
77
.
2
points
)
than
in
the
LR
lengthening
group
(
88
.
4
points
)
.
In
this
prospective
double
-blinded
study
,
retinacular
lengthening
showed
less
medial
instability
,
less
quadriceps
atrophy
,
and
a
better
clinical
outcome
at
2
years
compared
with
retinacular
release
.
We
believe
that
this
may
be
explained
by
the
controlled
preservation
of
the
lateral
patellar
muscle
-capsuloligamentous
continuity
after
retinacular
lengthening
.
Level
II
,
prospective
double
-blinded
comparative
study
.
Diseases
Validation
Diseases presenting
"pain"
symptom
achondroplasia
acute rheumatic fever
adrenal incidentaloma
adrenomyeloneuropathy
aniridia
aromatase deficiency
carcinoma of the gallbladder
cholangiocarcinoma
coats disease
congenital diaphragmatic hernia
congenital toxoplasmosis
cushing syndrome
cutaneous mastocytosis
cystinuria
dedifferentiated liposarcoma
dentin dysplasia
dracunculiasis
dystrophic epidermolysis bullosa
epidermolysis bullosa simplex
erdheim-chester disease
erythropoietic protoporphyria
esophageal adenocarcinoma
esophageal carcinoma
esophageal squamous cell carcinoma
fabry disease
familial mediterranean fever
focal myositis
hirschsprung disease
hodgkin lymphoma, classical
holt-oram syndrome
junctional epidermolysis bullosa
kabuki syndrome
kindler syndrome
lamellar ichthyosis
liposarcoma
locked-in syndrome
lymphangioleiomyomatosis
malignant atrophic papulosis
neuralgic amyotrophy
oligodontia
oral submucous fibrosis
papillon-lefèvre syndrome
phenylketonuria
pleomorphic liposarcoma
primary hyperoxaluria type 1
proteus syndrome
pyomyositis
scrub typhus
sneddon syndrome
systemic capillary leak syndrome
thoracic outlet syndrome
trochlear dysplasia
typhoid
von hippel-lindau disease
waldenström macroglobulinemia
well-differentiated liposarcoma
wolf-hirschhorn syndrome
This symptom has already been validated