Lateral Retinacular Release in Total Knee Arthroplasty With Patellar Replacement

Study Overview
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Brief Summary
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The aim of this study is to assess the effect of systematic lateral retinacular release on anterior knee pain, as well as its impact on the functional and radiological outcomes after total knee arthroplasty with patellar resurfacing.

Detailed Description
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Anterior knee pain is an important cause of persistent pain after total knee arthroplasty. Lateral retinacular release has been proposed as a procedure to prevent anterior knee pain syndrome, based on the reduction of lateral tension and improving patellar tracking. However, its effect on anterior knee pain after total knee arthroplasty is not clear when it is not strictly needed to correct maltracking. The purpose of this trial is to evaluate the effect of systematic lateral retinaculare release on anterior knee pain, peformed during a total knee arthroplasty with patellar resurfacing.

Official Title
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Systematic Lateral Retinacular Release Does Not Reduce Post-Operative Anterior Knee Pain After Primary Total Knee Arthroplasty With Patellar Replacement

Conditions
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Anterior Knee Pain Syndrome

Intervention / Treatment
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* Procedure: Lateral retinacular release


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: diagnosis of knee osteoarthritis Exclusion Criteria: prior major surgery on the same knee (high tibial or distal femoral osteotomy, patellar realignment) important preoperative malalignment (varus or valgus >15º or flexion deformity >15º) inability to sign informed consent

Ages Eligible for Study
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Minimum Age: 40 Years
Maximum Age: 90 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Lateral retinacular release group<br>During the implantation of a total knee arthroplasty a lateral retinacular release is performed | Procedure: Lateral retinacular release<br>* During the implantation of a total knee arthroplasty a lateral retinacular release is performed in the intervention group<br>|
| No Intervention: Non-release group<br>No aditional gesture in the lateral retinaculum is performed during the implantation of a total knee arthroplasty | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from baseline in Anterior Knee Pain at one year after surgery | Pressure pain threshold determined using pressure algometry | At the preoperative visit and at the 1-year follow up | 
| Change from baseline in Knee Pain measured by Visual Analogue Scale at one year after surgery | The Visual Analogue Scale referred by the patients at rest, when walking and when going up and downstairs. Scored between 0 (no pain at all) and 10 (maximum pain the patient could imagine). | At the preoperative visit and at the 1-year follow up | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from baseline in patellar pain and function at one year after surgery | Patellofemoral score designed by Feller, distributed with a maximum of 15 points for the intensity of anterior knee pain, 5 points for quadriceps strength, 5 points for the ability to rise from a chair and 5 points for stair climbing ability | At the preoperative visit and at the 1-year follow up | 
| Change from baseline in knee fuction, measured by the Knee Society Score, at one year after surgery | The Knee Society Score, being 0 the worst and 100 the best possible result | At the preoperative visit and at the 1-year follow up | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Total knee arthroplasty, Patellar resurfacing, Lateral retinacular release, Anterior knee pain