PT on the Net Research

Knee Surgery Rehab – Lateral Release


Question:

I have a client who had a lateral release (surgery) performed on his knee about five years ago. He also experiences limited motion, pain during activity and resistance training, a grinding sensation on the top of his knee cap and a strength discrepancy of his medial and lateral thighs. He had undergone physical therapy but still has lingering difficulties. We had started resistance training together, but it has seem to worsen the pain and limit the motion more so. What are some exercises and advice I can give him in order to regain some strength and reduce his pain during activity?

Answer:

Arthroscopic Lateral Retinacular Release is a procedure performed to correct problems with the patella (kneecap). It is performed arthroscopically, which means that the interior of the knee joint is examined using an endoscope that is inserted through a tiny portal incision.

This surgery is notorious for having a poor outcome. Something that can happen is a condition commonly called Patellar Baja. This is when scar tissue in the tendon below the patella (kneecap) can lead to a condition known as infrapatellar contracture syndrome, where the tendon progressively shortens and tugs the kneecap lower and lower on the thighbone, until it is in a position where the patient will experience pain and crunching on bending the knee (patella baja). The condition may also be precipitated if the cut for the lateral release curves up too high at the top of the kneecap. Patellar Baja is a very hard condition to fix.

I would work closely with the orthopedist who did the surgery. In the mean time, work on maintaining flexibility through stretching and body weight exercises. This will help break up the scar tissue. Good luck.