Medial RetinaculaDefinition:
Fibrous tissue on the medial side of the patella. It is a passive medial stabilizer of the knee to control patellar tracking. May become injured with poor flexibility, overuse or trauma (Senavongse). Subjective: Pain and tenderness on structure (medial side of patella). May be the source or a contributing factor of patella femoral pain syndrome (PFPS), repetitive or severe injury may lead to stretched/weakened or torn medial retinaculum (Dixit). Intervention: Rest and reduction in exercise or workload and possibly surgery. Note: Medial Retinaculitis-Rare condition seen almost exclusively in runners. Likely to be caused by a fatigue tear in the medial capsular insertion into the patella (Dutton). Diagnosis can be determined by a positive bone scan in medial edge of patella (Dutton). |
Lateral RetinaculaDefinition:
Fibrous tissue on the lateral side of the patella that helps to control patellar tracking. If too tight may cause excessive lateral tracking which may lead to a lateral retinaculum release (Juhn). A tight lateral retinaculum can tilt the patella leading to increased pressure on the lateral facet causing pain (Ficat). Subjective: Pain and tenderness on structure (lateral side of patella) (Juhn). Objective: Must rule out a tight iliotibial band (ITB) and weak quadriceps muscles (Juhn). Intervention: Taping the knee to promote medial glide and suggest a quality running shoe with arch support. If conservative treatment is unsuccessful recommend the lateral retinaculum release procedure, although this is thought to be an overused procedure (Juhn). |
References:
- Dutton M. Orthopaedic Examination, Evaluation, and Intervention. 2nd ed: The McGraw-Hill Companies, Inc.; 2008.
- Senavongse, W., Amis, A.A., The effects of articular, retinacular or muscular deficiencies on patellofemoral joint stability. JBJS, BR 2005. 87-B(4): p 577-582
- Dixit, Sameer M.D., Difiori, John M.D., Burton, Monique M.D., Mines, Brandon M.D. Management of Patellorfemoral Pain Syndrome. Am Fam Physician. 2007 Jan 15;75(2):194-202. http://www.aafp.org/afp/2007/0115/p194.html
- Ficat RP, Philippe J, Hungerford DS: Chondromalacia patellae: A system of classification. Clin Orthop 144: 55–62, 1979.
- Juhn, Mark S., D.O. Patellofemoral Pain Syndrome: A Review and Guidelines for Treatment. Am Fam Physician. 1999 Nov 1;60(7):2012-2018. http://www.aafp.org/afp/1999/1101/p2012.html
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