Lateral Release Vs. Tibia Tubercle Transfer

The human knees are a complex joint that supports almost our entire body weight. Something that many of us take advantage of and just expect it to work. Our knees are always at risk to injury. The simplest wrong move or knee pivot could toss your knee cap, medically known as the patella, out of place.

This wrong pivot happened to me. Both to my left and my right knees, my right knee survived, however it is weak and has to be supported by a knee brace, but the left knee is the main culprit. My left knee works as follows: for me to walk, kneel, or bend that left knee, the knee cap has to dislocate to the left side allowing me to perform normal bending and walking tasks. This causes severe pain and becomes increasingly problematic to the point where it interferes with activities of my daily living.

This condition is called Patellofemoral Instability, which ultimately requires either a lateral release or tibia tubercle transfer in order to stabilize my joint. My question, probably like many of you out there that may suffer from the same thing I have, wonder what are these two procedures, what has to be done, how long are you going to be off of your feet, and what are the long term effects? Here is what I found out.

The first choice given, the lateral release is a procedure done surgically, of course, and it is used to realign the kneecap by cutting on the outer side of the kneecap or from the inside of the knee and positioning it within the groove or track, where it is supposed to be, so it can glide up and down easier within that track for normal bending.

The surgery takes about 45 minutes and is done under anesthesia, obviously. The only downside that worries me is that after getting this procedure done, there is a possibility of bleeding into the joint which causes pain and swelling, along with other complication such as infection and scar tissue formation. I honestly don't care about a scar if it is going to fix my condition.

After the surgery, you will need to attend physical therapy and can take about a year before you are completely recovered, although the good news with choosing the lateral release surgery is that you will be only bound to a bed and crutches for a week or so.

The second option is the tibia tubercle transfer, doctor's state that this procedure is generally performed on those who have constant dislocation of their kneecap. The tibial tubercle transfer, sometimes called the Hauser procedure, is used to tightening up the knee improving stability.

In order to do this, the knee's tendon placement is changed and done by using pins or screws or even a block of bone taken from somewhere else in the body and fixing the tendon to a new point on the shin bone. Personally so far, I don't know if I like this idea...

I have also found out that this surgery doesn't restore long term function of the knee and can lead to arthritis. I can deal with arthritis, but I believe the whole idea of treatment is to restore the function of your knees for long term.

Some doctors have stated that I could loose the ability to kneel down and could have the possibility of damaging the Popliteal artery in the knee that supplies blood to my knee join as well as the muscles in the knee.

After the surgery, I am told that the same after surgery activities apply crutches, bed rest, and plenty of physical therapy. However one of the other irritating facts that I had found out was that the Hauser procedure is said to no longer be done. Doctors have also stated that the operation prevents further dislocation however the procedure has caused some peoples knees to over straighten.

After looking at my two options, I believe the lateral release would be the most promising, however if any of the readers out there have had any experience with any of these procedures, I would gladly appreciate your input!

In conclusion, working with your physical therapy sessions should be your first choice before considering the surgical alternatives. Why? Because there can be serious life altering long term complications.

Good luck!