Recurrent dislocation of the patella, or kneecap, occurs when the kneecap does not track properly through the corresponding groove in the femur, or thigh bone. Repeated occurrences of dislocation can cause significant damage to the cartilage joint surfaces of both the patella and femur. Soft tissue patellar realignment procedures are frequently performed during knee arthroscopy as well as total knee replacements. The most common surgical procedure for patellar tracking problems is the lateral release. It can be performed either as an open procedure, or arthroscopically. It is meant to correct tracking issues and more centrally align the kneecap during range of motion. However, patients should be aware of side effects that may occur after lateral release surgery.
Infection
As with any surgical procedure, wound infection is a valid concern and is addressed with caution and respect. Infections typically arise from opportunistic microorganisms that normally inhabit the skin and are provided a means of entry into the body by way of an incision. Surgical wound infections can occur in either method of performing a lateral release. Arthroscopic portals, although no bigger than stab wounds, can become infected after a lateral release procedure.
Medial Subluxation
In the course of correcting recurrent lateral patellar dislocations, medial subluxation, or partial dislocation in the opposite direction, has emerged as a real complication of lateral release surgery. J.C. Hughston reports in the "American Journal of Sports Medicine" that, of 54 knees evaluated in his study for lateral releases, 30 had developed medial patella subluxation. Although a new complication in the field of arthroscopy, it was very real and was in evidence in over half of the knees studied.
Hemarthrosis
Hemarthrosis, or a collection of blood within the knee joint, can develop as a result of performing a lateral release procedure. Hemarthrosis occurs when small blood vessels, especially a branch of the geniculate artery that passes along the lateral, or outer portion of the knee capsular tissue adjacent to the patella, are cut.
In a study published in "Arthroscopy" in 1992, approximately 13 percent of a total of 50 patients seen over a three-year follow-up period, displayed hemarthrosis as a postoperative complication.
Persistent Knee Pain
If damage to the joint cartilage surfaces of the patella and corresponding trochlea, or groove of the thigh bone, has occurred prior to the lateral release procedure, compressive forces upon those damaged areas from the change in balance of the kneecap during range of motion can contribute to persistent anterior, or frontal, knee pain.
