I had a lateral retinaculum release for a chronically dislocating patella. My symptoms aren’t any better. In fact, the pain may be worse. What went wrong?

From a mechanical point of view, the lateral retinacular release (LRR) can’t always correct the cause of patellar instability. This is especially true if the problem is a defect in the anatomy. The bone underneath the kneecap may be misshapen or the ligament may be deficient. Cutting the retinaculum won’t change that.

In some cases a lateral release can make a patient worse. If the retinaculum on the other side of the knee (medial) isn’t strong enough, releasing the lateral side can make the excessive patellar motion even greater. This may be what happened to you.

A rehab program may be needed. Strengthening the quadriceps muscle that controls the kneecap can be helpful. A physical therapist can examine the four parts of the quadriceps muscle. If any one section is pulling unevenly it could be contributing to the problem. Proper alignment may depend on muscular strength and coordination.