Which Treatment Works Best for Lateral Patellar Compression Syndrome?

Anterior knee pain is a common problem affecting millions of people worldwide. It is a debilitating symptom that reduces mobility and adversely affects the quality of life.
A clinical trial compared two different treatment options for lateral patellar compression syndrome (a known cause of anterior knee pain in young adults). Researchers wanted to find out if open or arthroscopic surgery provided better results.

What is Lateral Patellar Compression Syndrome?

Lateral patellar compression syndrome is a common condition that causes pain around the kneecap. It often affects athletes and individuals who engage in activities that involve repetitive knee movements, such as running or jumping. The syndrome occurs when the patella (kneecap) is compressed and rubs against the femur (thigh bone), leading to inflammation and discomfort. It is caused by a tight lateral retinaculum.

The first line of treatment is conservative involving rest and physiotherapy. However, when the conservative treatment of lateral patellar compression syndrome fails, surgical treatment can be done by the release of the tight lateral patellar retinaculum either by open or arthroscopic technique.

Clinical Trial

In this clinical trial, researchers compared the effectiveness of open and arthroscopic release in treating lateral patellar compression syndrome. Open release involves making a larger incision to access and release the tight tissues around the kneecap, while the arthroscopic release is a minimally invasive procedure using small incisions and a camera for guidance. The goal was to determine which method produced better functional outcomes.

A group of 80 individuals diagnosed with lateral patellar compression syndrome was randomly assigned to either the open or arthroscopic release group. Group A (40 patients) was treated with open release while Group B (40 patients) was treated by arthroscopic release. All these patients were diagnosed with lateral patellar compression syndrome depending on clinical features and MRI.

The participants were assessed by the Lysholm knee scoring scale (which is a patient-reported instrument that consists of subscales for pain, instability, locking, swelling, limp, stair climbing, squatting, and needs for support) before surgery and at periods of 2, 6 weeks, 6, 12, and 24 months after surgery.

Results

The results of the study showed that both open and arthroscopic release procedures significantly improved the functional abilities of individuals with lateral patellar compression syndrome. However, the arthroscopic release group demonstrated significantly better outcomes in terms of pain relief and overall satisfaction.

Although both methods were effective, the minimally invasive arthroscopic release offered advantages such as smaller incisions, lower post-operative knee pain, and better functional outcomes.

Additionally, there was no recurrence in either group, but there were 4 patients who developed medial patellar instability in the group of open release.

Conclusion

This clinical trial compared two surgical treatments, open and arthroscopic release, for lateral patellar compression syndrome. The findings indicated that both procedures provided pain relief and improved functionality. However, the arthroscopic release approach showed significantly better results and additional benefits. It's important to consult with a healthcare professional to determine the most suitable treatment option based on individual needs and circumstances.

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