The structural properties of the lateral retinaculum and capsular complex of the knee

Although lateral retinacular releases are not uncommon, there is very little scientific knowledge about the properties of these tissues, on which to base a rationale for the surgery. We hypothesised that we could identify specific tissue bands and measure their structural properties. Eight fresh-frozen knees were dissected, and the lateral soft tissues prepared into three distinct structures: a broad tissue band linking the iliotibial band (ITB) to the patella, and two capsular ligaments: patellofemoral and patellomeniscal. These were individually tensile tested to failure by gripping the patella in a vice jaw and the soft tissues in a freezing clamp. Results: the ITB–patellar band was strongest, at a mean of 582 N, and stiffest, at 97 N/mm. The patellofemoral ligament failed at 172 N with 16 N/mm stiffness; the patellomeniscal ligament failed at 85 N, with 13 N/mm stiffness. These structural properties suggest that most of the load in-vivo is transmitted to the patella by the transverse fibres that originate from the ITB.