Thermal medial retinaculum shrinkage and lateral release for the treatment of recurrent patellar instability

Purpose: To study a technique of medial retinacular thermal shrinkage and evaluate the clinical effectiveness of this technique. Type of Study: Nonrandomized prospective case series. Methods: A consecutive series of patients with recurrent patellar instability treated with arthroscopic lateral release and medial thermal retinaculum shrinkage using a monopolar radiofrequency probe was assessed subjectively by visual analog scale and both preoperatively and postoperatively by physical examination and Lysholm and Fulkerson knee scores. Results: We evaluated 53 knees with an average follow-up of 53 months (range, 24 to 88 months). The mean Lysholm and Fulkerson scores improved from 45 and 41 to 81 and 82, respectively. Subjectively, 48 of 53 knees (90%) were reported as excellent or good. The average visual analog scale score was 8 out of 10. Five patients failed because of recurrent dislocation (9% recurrence). Additional stabilization procedures were performed in 4 patients. Conclusions: Medial shrinkage using monopolar thermal energy is effective in treating recurrent patellar instability. Our results were comparable with prior studies using suture plication. The technique avoids additional incisions and decreases operative time. Level of Evidence: Level IV, therapeutic prospective cohort study.