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Objective <p>To evaluate the efficacy and safety of lateral patellar retinacular release (LPRR) versus no release in total knee arthroplasty (TKA).</p> Methods <p>This PRISMA-compliant systematic review searched PubMed, Embase, Web of Science, Cochrane Library, CNKI, CBM, Wanfang, and VIP from inception to August 2024. We included comparative studies of TKA patients with vs without LPRR (<i>n</i> = 8 studies, 3,911 patients). Exclusion criteria: incomplete data, combined procedures, cadaveric/artificial models. Random-effects models analyzed outcomes; heterogeneity assessed via <i>I</i><sup>2</sup> statistics.</p> Results <p>Primary outcomes: LPRR significantly reduced anterior knee pain (OR = 0.23, 95% CI 0.13–0.42, <i>P</i> &lt; 0.00001; I<sup>2</sup> = 0%) and improved Knee Society Score (KSS) (MD = 3.00, 95% CI 1.10–4.89, <i>P</i> = 0.002; <i>I</i><sup>2</sup> = 0%) but increased infection rate (OR = 3.44, 95%CI 1.48–8.04, <i>P</i> = 0.004; <i>I</i><sup>2</sup> = 26%). Secondary outcomes showed no significant differences (<i>P</i> &gt; 0.05).</p> Conclusion <p>LPRR reduces anterior knee pain but significantly increases infection risk (NNH = 32). Should be reserved for patients with intraoperative patellar maltracking after risk–benefit assessment. Findings are limited by predominant Asian cohorts, short follow-up durations, and heterogeneous surgical indications.</p>

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Efficacy of lateral retinacular release versus no release in total knee arthroplasty: a systematic review and meta-analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年9月29日

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  • Yue Zou,
  • Cuiqin Cao,
  • Xiujiang Sun,
  • Guodong Zhang

摘要

Objective

To evaluate the efficacy and safety of lateral patellar retinacular release (LPRR) versus no release in total knee arthroplasty (TKA).

Methods

This PRISMA-compliant systematic review searched PubMed, Embase, Web of Science, Cochrane Library, CNKI, CBM, Wanfang, and VIP from inception to August 2024. We included comparative studies of TKA patients with vs without LPRR (n = 8 studies, 3,911 patients). Exclusion criteria: incomplete data, combined procedures, cadaveric/artificial models. Random-effects models analyzed outcomes; heterogeneity assessed via I2 statistics.

Results

Primary outcomes: LPRR significantly reduced anterior knee pain (OR = 0.23, 95% CI 0.13–0.42, P < 0.00001; I2 = 0%) and improved Knee Society Score (KSS) (MD = 3.00, 95% CI 1.10–4.89, P = 0.002; I2 = 0%) but increased infection rate (OR = 3.44, 95%CI 1.48–8.04, P = 0.004; I2 = 26%). Secondary outcomes showed no significant differences (P > 0.05).

Conclusion

LPRR reduces anterior knee pain but significantly increases infection risk (NNH = 32). Should be reserved for patients with intraoperative patellar maltracking after risk–benefit assessment. Findings are limited by predominant Asian cohorts, short follow-up durations, and heterogeneous surgical indications.