Lateral Patellofemoral Anatomy and Surgery

Strict balancing between lateral and medial patellar restraints is crucial to maintain a proper patellofemoral environment. Lateral patellofemoral abnormalities, ranging from excessive tightness to excessive laxity of the lateral retinaculum, may disrupt the restraint balancing and result in patellofemoral disorders, such as lateral patellar instability, patellar compression syndrome, and iatrogenic medial patellar instability. Appropriate surgical procedures can prevent or overcome the lateral patellofemoral abnormalities, improving patellar tracking and the clinical outcomes. This chapter explores the anatomy of lateral retinaculum and its role in patellofemoral disorders. In addition, surgical techniques to address lateral retinaculum tightness are described.