Arthroscopic release of the lateral quadriceps retinaculum is performed to relieve lateral tracking or tilting of the patella caused by tight lateral bands. Medial reefing may be carried out where further correction of lateral tracking is required. Progression then follows as for lateral release but the patient may be slower to regain flexion.
N.B. (i) The protocol may change with the presence of other pathology.
........(ii) There may be a haemarthrosis.
ACUTE STAGE (Immediately post-op)
Elevate the limb when resting
Muscle pump exercises
Patellar mobilisations (gentle)
Gentle flexion within pain free range
P.W.B./F.W.B. as comfortable
Dressing - T.E.D. stocking or crepe bandage with a pad over the lateral aspect to apply pressure to the site of release. Continue with this until fully weight bearing and swelling has resolved.
Check wounds. Reassure patient that the ‘egg-like’ swelling (if present) on the lateral aspect is normal and will gradually be reabsorbed.
Progress to F.W.B. if necessary
Check patellar mobilisations
Increase flexion gently
Progressive mobilising and strengthening exercises eg. step ups, mini squats, static bike
CONDITIONS FOR DISCHARGE
Discharge can be anything from six to twelve weeks:
1) Reduced swelling and pain
2) Full range of movement
3) Improved timing of V.M.O.
4) Patient is aware of importance of continuing exercises
5) Normal function for the individual patient