Effect of the iliotibial band on knee biomechanics during a simulated pivot shift test

Yamamoto, Yuji; Hsu, Wei‐Hsiu; Fisk, Jesse A.; Scyoc, Andrew H. Van; Miura, Kazutomo; Woo, Savio L‐Y.

doi:10.1002/jor.20122

Cited by 69 publications

(65 citation statements)

References 25 publications

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“…9 The rationale for selecting 30 N for the iliotibial force was based on past work. 7,8 At least 30 N is required experimentally to produce a positive pivot shift in an anterior cruciate ligament (ACL) deficient knee.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 On the lateral side, although less investigated, a similar effect can be expected, because of the interconnections of the iliotibial band (ITB) to the patella that provide lateral retinacular restraint to the patella. [3][4][5][6] Previous studies have shown a significant effect of the ITB on tibiofemoral [7][8][9] and patellofemoral kinematics and contact areas. 8 The current study measured patellar stability, defined in the objective engineering sense, as the ''restraining force'' required to oppose patellar displacement from the equilibrium position.…”

mentioning

confidence: 99%

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Iliotibial band tension reduces patellar lateral stability

Merican

Iranpour

Amis

2009

Journal Orthopaedic Research

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This study investigated the effect of loading the iliotibial band (ITB) on the stability of the patellofemoral joint. We measured the restraining force required to displace the patella 10 mm medially and laterally (defined as medial and lateral stability, respectively) in 14 fresh-frozen knees from 0 to 908 knee flexion. The testing rig allowed the patella to rotate and translate freely during this displacement. The quadriceps was separated into five components and loaded with 175 N total tension. Testing was performed at 0 to 90 N ITB tension. With no ITB tension, the lateral restraining force ranged from 82 to 101 N across 0 to 908 flexion. Increasing ITB tension caused progressive reduction of the lateral restraining force. The maximum reduction was 25% at 608 flexion and 90 N ITB tension. Medial restraining force increased progressively with increasing knee flexion and increasing ITB loads; it ranged from 74 N at 08 knee flexion and 0 N ITB tension to 211 N at 908 knee flexion and 90 N ITB tension. The maximum effect was an increase of medial restraining force of 50% at 908 flexion and 90 N ITB tension. ß

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Iliotibial band tension reduces patellar lateral stability

Merican

Iranpour

Amis

2009

Journal Orthopaedic Research

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“…Additionally, other studies highlighted the role of the iliotibial band 143 (ITB) as an "ACL agonist" (Yamamoto et al, 2006) and, provided the ACL is resected first, 144 the secondary restraint from the medial meniscus (MM) (Allen et al, 2000; Levy et al, 1982). 145…”

Section: Anterior Translation 134mentioning

confidence: 99%

Clinical biomechanics of instability related to total knee arthroplasty

Athwal

Hunt

Davies

et al. 2014

Clinical Biomechanics

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Background: Tibiofemoral instability is a common reason for total knee arthroplasty failure, and may be attributed to soft tissue deficiency and incorrect ligament balancing. There are many different designs of implant with varying levels of constraint to overcome this instability; however there is little advice for surgeons to assess which is suitable for a specific patient, and soft tissue balance testing during arthroplasty is very subjective. Method: The current theories on primary and secondary soft tissue restraints to anterior/ posterior, varus/ valgus, and internal/ external rotational motion of the knee are discussed. The paper reviews biomechanics literature to evaluate instability in the intact and implanted knee. Findings: The paper highlights important intra-and extra-capsular structures in the knee and describes the techniques used by clinicians to assess instability perioperatively. In vitro cadaveric studies were found to be a very useful tool in comparing different implants and contributions of different soft tissues. Interpretation: In vitro cadaveric studies can be utilised in helping less experienced surgeons with soft tissue releases and determining the correct implant. For this to happen, more biomechanical studies must be done to show the impact of release sequences on implanted cadavers, as well as determining if increasingly constrained implants restore the stability of the knee to pre-deficient conditions.

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“…Dissection of the anterolateral capsule or iliotibial band (ITB) or both results in increased rotational movement in ACL-deficient knees, indicating a secondary role of these structures in rotational stability. These results were obtained in cadaveric studies, with the individual use of a navigation system, electrogoniometer and robotic testing system to document objective knee movement [14,48,55,56]. Recently, the ITB has been demonstrated to have large contributions in the restraint of lateral tibial translation and tibial internal rotation [57•].…”

Section: Anatomical and Biomechanical Implications Of The Anterolatermentioning

confidence: 99%

“…However, research has shown that resection of the ITB may diminish reduction of the tibia during the pivot shift test [58]. In addition, the ITB acts as an ACL agonist, suggesting that using an ITB graft for extraarticular reconstruction may hinder its function as a restraint to the knee [56].…”

Section: Anatomical and Biomechanical Implications Of The Anterolatermentioning

confidence: 99%

Basic biomechanic principles of knee instability

Zlotnicki

Naendrup

Ferrer

et al. 2016

Curr Rev Musculoskelet Med

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Motion at the knee joint is a complex mechanical phenomenon. Stability is provided by a combination of static and dynamic structures that work in concert to prevent excessive movement or instability that is inherent in various knee injuries. The anterior cruciate ligament (ACL) is a main stabilizer of the knee, providing both translational and rotatory constraint. Despite the high volume of research directed at native ACL function, pathogenesis and surgical reconstruction of this structure, a gold standard for objective quantification of injury and subsequent repair, has not been demonstrated. Furthermore, recent studies have suggested that novel anatomic structures may play a significant role in knee stability. The use of biomechanical principles and testing techniques provides essential objective/quantitative information on the function of bone, ligaments, joint capsule, and other contributing soft tissues in response to various loading conditions. This review discusses the principles of biomechanics in relation to knee stability, with a focus on the objective quantification of knee stability, the individual contributions of specific knee structures to stability, and the most recent technological advances in the biomechanical evaluation of the knee joint.

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Effect of the iliotibial band on knee biomechanics during a simulated pivot shift test

Cited by 69 publications

References 25 publications

Iliotibial band tension reduces patellar lateral stability

Iliotibial band tension reduces patellar lateral stability

Clinical biomechanics of instability related to total knee arthroplasty

Basic biomechanic principles of knee instability

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