Objective: To investigate the method and effect of arthroscopic lateral patella retinaculum releasing (LPRR) through/outside synovial membrane for the treatment of lateral patellar compression syndrome (LPCS).
Methods: From September 2014 to December 2017, 125 patients with LPCS underwent arthroscopic LPRR through/outside synovial membrane combined with joint debridement. In the outside synovial membrane (OSM) group, the joint was cleaned first. The surface of lateral patella retinaculum (LPR) was created the chamber for arthroscopic operation. The LPR was released under the arthroscopy, and the synovial membrane was retained. In the through synovial membrane (TSM) group, the joint was cleaned first, and the synovial membrane, joint capsule and LPR, and superficial fascia were gradually incised from the joint cavity to the subcutaneous tissue. The synovial membrane was cut open. Active rehabilitation training was conducted after surgery. Before and after surgery, Lysholm score, patella medial shift, Kujala score, VAS score and surgical complications were evaluated and compared.
Results: All patients in this study were followed up for 1.5-5 years. All patients had significant reduction in knee pain and improved function after 1 month and 1 year. The final follow-up of the Lysholm score, the distance of patella medial shift, the Kujala score, and the VAS score in the OSM group and the TSM group were significantly improved compared with those before surgery (P<0.001), but these observed targets at the last follow-up and before surgery between the two groups were compared with no statistical differences. In the TSM group, 5 patients had hemarthrosis and 3 cases joint adhesion. There were no postoperative complications in the OSM group.
Conclusion: Arthroscopic closing LPRR for the treatment of LPCS can effectively improve the function and symptoms of the patellofemoral joint. It has the advantages of small trauma, good effect and rapid recovery. Among them, the hemarthrosis and joint adhesion in the TSM group were significantly higher than those in the OSM group, and arthroscopic closing LPRR outside synovial membrane was more advantageous.