The Pie Crust Lateral Release Technique Compared to Traditional Lateral Release Techniques in Cadaveric Study

The Pie Crust Lateral Release TechniqueCompared to Traditional Lateral ReleaseTechniques in a Cadaveric StudySS-68April 16, 2:45 PMWILL BROOKS, B.S., PRESENTING AUTHORBART MCKINNEY, M.D.KENT REINHART, B.S.BRIAN JOHNSTON,PH.D.Introduction: Lateral patellar compression syndrome isa known cause of chronic anterior knee pain. For patientswho have failed conservative treatment, arthroscopiclateral retinacular release is indicated. This procedure hasbeen found to have potential sequelae on patellar insta-bility with iatrogenic medial patellar instability being themost common problem. Recent studies have shown thatthe “pie crust�method of incision had positive results onpatellar instability when implemented with total kneereplacements. This study was designed to see if the piecrust method could be a potential arthroscopic surgicaltechnique used for lateral retinacular releases in order toalleviate lateral compression.Methods: Using 15 cadaveric knees, the pie crust methodwas performed on 7 knees and the traditional releaseswere performed on 8 knees. The pie crust method wasperformed by using a horizontal stab 1cm in betweenstabs. K-wires were drilled into the knees to providelandmarks for measurement with digital calipers. Thenlateral translation, medial translation, and patellar tiltlaxity measurements of the knee cap were made on eachof these knees using 0 Newtons, 22 Newtons, and 50Newtons of force.Results: This study found that the pie crust methodincreased lateral tilt and lateral retinacular laxity compa-rable to traditional lateral release techniques. However thepie crust method had a lower percent change of medialtranslation at both 22 N and 50 N (p value 0.0125, p value0.011 respectively) compared to the traditional releases onpatellar stability.Conclusion: The pie crust method improved tension andincreased the lateral patellar tilt on the lateral patella withless subsequent medial instability compared to traditionalreleases. These results showed that the pie crust methodcould be a viable option for relieving the lateral patellarcompression syndrome