Review Question - QID 3303

An isolated release of the popliteus tendon during TKA is most appropriate in the setting of a valgus knee deformity that is tight in flexion.

Lateral collateral ligament release is most appropriate for a valgus deformity that is tight in both flexion and extension. Iliotibial band release is indicated if the knee is tight in extension. For varus knee deformities, femoral and tibial osteophyte removal, release of the deep MCL, release of the posteromedial corner, release of the attachment of the semimembranosus, and partial superficial MCL release may be sequentially indicated to achieve coronal balancing.

The review article by Favorito et al discusses the controversy over the correct order and sequence for anatomic release of the lateral structures with some authors preferring not to release the LCL as an initial step.

The case-control study by Krackow et al found good success with a lateral release in valgus deformity that had competent medial structures. In cases with incompetent medial structures they reported good success with reconstruction and imbrication of the medial structures.