The lateral edge of the patella is identified by the surgeon's finger and the lateral ligament incision is performed with a blade through the skin.

Under short-acting general anesthesia, the patient lies supine. The surgeon palpates to identify the lateral border of the patella; typically, the surgeon's left thumb is placed at the midpoint of this lateral edge. Using a No. 11 scalpel blade, an incision is made parallel to the lateral border of the patella-approximately 5 mm away-extending through the skin, subcutaneous layers, and lateral retinaculum, and penetrating the knee's synovial membrane to enter the joint space. This creates a small "keyhole" opening suitable for knee arthroscopy, with the sharp edge of the blade initially oriented toward the patient's head.

The tip of the blade is then angled inward into the joint to incise the lateral retinaculum superiorly, without enlarging the initial skin puncture.

The blade is then rotated 180 degrees so that its sharp edge faces toward the patient's feet. The inferior portion is incised by angling the blade inward through the subcutaneous layers, lateral retinaculum, and synovial membrane into the joint, while maintaining the original shape and size of the skin puncture without enlargement.

A sterile dressing and a compression bandage are then applied, and the patient is encouraged to begin early mobilization.

3. Comparison of Clinical Success Rates Surgical Goal Isolated Release Release + Realignment Stability Success ~77.3% ~93.6% Recurrence Rate Higher (odds ~0.29) Lower (odds ~0.06)

Inclusion Criteria:

• Retropatellar Pain
• Lateral Patellar Pain

Exclusion Criteria:

• Knee Arthritis grade 4
• Totally Knee Arthritis