A prospective study analyzing the effects of intraoperative lateral patellar release for patellar instability in total condylar knee arthroplasty demonstrated that lateral release was successful in preventing postoperative patellar instability. Division of the superolateral geniculate vessels resulted in an increased incidence of wound discoloration (P < .01) and superficial wound infection (P < .05). Perioperative transcutaneous measurement of the skin oxygen tension demonstrated an objective reduction in lateral wound edge skin viability following lateral release (P < .02). A lower threshold for performing lateral patellar release is necessary. To preserve the viability of the lateral skin edge, lateral release should be performed using the intracapsular approach with preservation of the superolateral geniculate vessels.