The Lateral Side: When and How to Release, Lengthen, and Reconstruct

Clin Sports Med. 2022 Jan;41(1):171-183. doi: 10.1016/j.csm.2021.07.007.


The lateral patellofemoral complex is an important stabilizer to medial and lateral displacement of the patella. Soft tissue abnormalities can range from pathologic tightness to laxity, presenting with symptoms related to patellar instability, anterior knee pain, or arthritis. Clinical evaluation should be performed to confirm patellar dislocation, assess the integrity of the lateral and medial soft tissues, and explore other pathoanatomic factors that may need to be addressed. Lateral retinacular lengthening is recommended over lateral release owing to the potential of iatrogenic medial instability with release, and a lateral patellofemoral ligament reconstruction can be performed to effectively treat medial instability.

Keywords: LPFL; Lateral retinaculum; Lengthening; Medial instability; Reconstruction; Release.

Publication types

  • Review

MeSH terms

  • Humans
  • Joint Instability* / surgery
  • Ligaments, Articular / surgery
  • Patella
  • Patellar Dislocation* / surgery
  • Patellofemoral Joint* / surgery