Lateral Release

by John

I had a lateral release 6 months ago on my right knee, and a lateral release on my left knee 1 month ago, both along with a plica resection.

My right knee is now actually worse that it was before. Prior to the operation I only had pain after running or cycling, now it causes pain walking up stairs or during other ordinary activities. Also if I straighten my leg I get a quite loud popping noise, which I never had before.

My physio seems to think I may need to have it operated on again, but has given me lots of stretches for my ITB and strengthening exercises for my VMO while I wait to see the surgeon again.

I'm keen to avoid surgery again if at all possible, do you have any suggestions as to anything else I can do.

Also do you have any idea why it is worse than before the operation.

Thanks in advance


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Feb 19, 2008
Don't forget the hips...
by: Bart - SII

John, your situation is unfortunately common. I have had several patients who had a lateral release and actually felt worse after the surgery. I can't comment specifically about your situation because I am not your therapist, but I can give you some information about my for thought if you will.

Lateral release has its place as a good option for knee pain if the underlying problem is lateral tilt, lateral tracking, or a problematic plica. If you don't have these things, then the procedure could cause more problems than good. This is usually because the patella becomes more mobile and so it moves even more than before the surgery.

The most commonly overlooked area for treating knee pain before and after surgery is hip strengthening and neuromuscular control. So much emphasis is placed on the VMO that the hips are forgotten. You can strengthen the VMO all you want - it has no bearing on where the femur goes during activities...and wherever the femur goes, the patella follows.

I treat patients in the clinic everyday who have knee pain from patella femoral syndrome and I do very little along the lines of isolating the VMO. I strengthen the hips through functional exercises and things get better.

This approach is progressive but it works. Sometimes surgery is needed, but often it can be avoided.

I would recommend you talk to your physio and ask about exercises to strengthen your hips - specifically your external rotators and abductors - and to improve your neuromuscular control . You can also look through some of the information I provide on Sports Injury Rehab for some exercise ideas you can discuss with your physio.

I hope this helps...feel free to comment back with more questions.

Apr 21, 2009
Lateral release and plica release 2wks ago
by: Anonymous

John- Sorry to hear about your pain. I too am having worse pain following my surgery. I yet have quite a bit of swelling due to the surgery which was just two weeks ago. So i am hoping over the next few weeks things will get better. i have an awesome therapist who is working with me to get better. i wish you the best and hope things work out.

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