Factors Associated With the Decision to Perform a Lateral Retinacular Release or Lengthening During Medial Patellofemoral Ligament Reconstruction in the JUPITER Cohort.
Background: Medial patellofemoral ligament reconstruction (MPFLR) is a standard treatment for patellofemoral instability. Concomitant lateral retinacular release (LR) or lateral retinacular lengthening (LL) is considered for patients with a tight lateral retinaculum (as determined by examination und...
| Publicado en: | Orthopaedic Journal of Sports Medicine Vol. 14; no. 2; pp. 1 - 8 |
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| Autores principales: | , , , , , , , , , , , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Sage Publications Inc.
Feb2026
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=191984359&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 191984359 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 23259671 FUGT jtl: Orthopaedic Journal of Sports Medicine issn: 23259671 maglogo: Y pubinfo: dt: Feb2026 vid: 14 iid: 2 pid: 344 pub: Sage Publications Inc. place: Thousand Oaks, California artinfo: ui: 191984359 191984359 191984359 10.1177/23259671251331038 191984359 ppf: 1 ppct: 7 formats: tig: atl: Factors Associated With the Decision to Perform a Lateral Retinacular Release or Lengthening During Medial Patellofemoral Ligament Reconstruction in the JUPITER Cohort. aug: au: Bram, Joshua T. Lijesen, Emilie Green, Daniel W. Heyworth, Benton E. Wilson, Philip L. Shubin Stein, Beth E. Parikh, Shital N. Wall, Eric J. Yanke, Adam B. Brady, Jacqueline M. Redler, Lauren H. Farr, Jack Strickland, Sabrina M. Fabricant, Peter D. Koh, Jason L. Yen, Yi-Meng Kramer, Dennis Milewski, Matthew Tompkins, Marc Chambers, Caitlin affil: Hospital for Special Surgery, New York, New York, USA sug: subj: Patellar Ligament Surgery Knee Joint Surgery Joint Instability Surgery Surgery, Reconstructive Decision Making, Clinical Physical Examination Bone Lengthening Methods Human Male Female Child Adult Cross Sectional Studies Prospective Studies Multicenter Studies Descriptive Statistics Mann-Whitney U Test T-Tests Chi Square Test Fisher's Exact Test Logistic Regression Data Analysis Software Surgical Patients Sex Factors Sports Medicine Medical Fellowships Osteotomy Anesthesia Clinical Assessment Tools Child: 6-12 years Adult: 19-44 years Male Female ab: Background: Medial patellofemoral ligament reconstruction (MPFLR) is a standard treatment for patellofemoral instability. Concomitant lateral retinacular release (LR) or lateral retinacular lengthening (LL) is considered for patients with a tight lateral retinaculum (as determined by examination under anesthesia); however, the literature is limited on the frequency of these procedures and the factors associated with their incidence. Purpose: To investigate associations between demographic characteristics, physical examination findings, and radiologically measured patellofemoral parameters with LR/LL in patients undergoing primary MPFLR. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A prospective multicenter cohort study database was queried for patients who underwent primary MPFLR between January 2017 and July 2022. A total of 23 surgeons from academic centers across the United States performed the procedures. Radiologic parameters, concomitant procedures, and pre- and intraoperative physical examination findings were assessed between patients with and without LR/LL using the chi-square test, independent t test, or Mann-Whitney U test, as appropriate. Binary logistic regression was used to perform a multivariable analysis of factors associated with LR/LL. Results: Of 428 patients (mean age, 16.7 ± 4.2 years, 64.5% women), 22.9% underwent LR (13.6%) or LL (9.3%). Those who underwent LR/LL were more frequently men (44% vs 23%; P =.049), had lower Beighton scores (2.6 ± 2.7 vs 3.8 ± 2.9; P <.001), and their surgeons were more likely to have completed a sports fellowship (82.7% vs 64.8%; P <.001) compared with those who did not undergo LR/LL. On preoperative examination, patients with LR/LL more often exhibited patellar apprehension (92.6% vs 81.2%; P =.008) and pathologic lateral patellar translation (62.2% vs 49.1%; P =.012). Intraoperatively, patients with LR/LL more often dislocated in extension during examination under anesthesia (70.4% vs 57%; P =.017) and underwent a tibial tubercle osteotomy (TTO) (35.7% vs 9.4%; P <.001). A total of 168 patients had preoperative imaging measurements available, and patients with LR/LL showed greater patellar tilt (24.1°± 7.7° vs 18.5°± 16.7°; P <.001). Conclusion: Approximately 23% of patients who underwent MPLFR from a large multicenter cohort underwent LR/LL. The LR/LL appears to be associated with less ligamentous laxity, lateral patellar apprehension, surgeon completion of a sports fellowship, and concomitant TTO. These data may elucidate some of the relative factors associated with performing these procedures in patients undergoing primary MPFLR. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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