Is lateral retinacular release still a valid surgical option? From release to lengthening

In 1974 Merchant and Mercer (1), for the first time in medical literature, refer to the surgical technique they called “lateral release of the patella”. This technique consisted of an “isolated release of the lateral patellar retinaculum and capsule”. One year later, in 1975, Ficat et al. published in French literature the section of what he called the “lateral patellar ligament”, which was really none other than the lateral retinaculum (LR) (2). The objective of this surgical technique was to treat a radioclinical entity described in 1972 by him called “syndrome of external hyperpressure of the patella” (3). However, in the conclusion of the paper by Ficat et al. in 1972 he briefly mentions the “section de l’aileron externe” (3). Since then and up to a few years ago this technique, currently called lateral retinacular release (LRR), has become popular worldwide among orthopedic surgeons (4). The reasons were pretty obvious, it was a very easy technique, accessible to the average orthopedic surgeon, and also because it was considered as a “minor surgery”. The last, from our point of view, is a great mistake. We frequently hear these words when talking about the LRR: “I am going to perform a very minor surgery that can do you no harm, and still leaves the door open for more aggressive realignment procedures”. There is nothing further from the truth. This way of thinking is a big mistake that has led to many problems; there are no “minor surgeries” only “minor surgeons”.