Iliotibial Band Lengthening: An Arthroscopic Surgical Technique

Pierce, Todd P.; Mease, Samuel J.; Issa, Kimona; Festa, Anthony; McInerney, Vincent K.; Scillia, Anthony J.

doi:10.1016/j.eats.2017.02.010

Cited by 8 publications

(5 citation statements)

References 19 publications

(31 reference statements)

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“…However, none of the previous studies used a combined arthroscopic technique for sub-iliotibial release and elongation of the ITB, representing global management of ITBS. Pierce et al (20) described a combined technique adding arthroscopic lengthening of the ITP through incisions with Metzenbaum scissors at proximal, distal, anterior and posterior level of the ITB, from its point of insertion in Gerdy's tubercle. However, to our knowledge, no previous studies have evaluated the results of arthroscopic management combining both techniques in a prospective series of patients.…”

Section: Discussionmentioning

confidence: 99%

All-inside Arthroscopic Release for Iliotibial Band Syndrome. Description of Surgical Technique and Short-term Results

Arnal-Burró

Vidal-Fernández

Igualada-Blázquez

et al. 2022

Preprint

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Introduction: Description of an arthroscopic procedure (all-inside arthroscopic release, AIAR) that combines all the possible interventions on the iliotibial band (ITB), and evaluates its outcomes in a group of distance runners diagnosed with ITBS. Methods A prospective observational study was made of distance runners diagnosed with ITBS and operated upon using the AIAR technique between 1 January 2018 and 31 June 2020. The surgical technique is described in detail, and the demographic data and functional outcomes measured by the ARS and IKDC sports performance scales are presented. Results A total of 14 patients were included, with a mean follow-up of 16 months (range 12–42 months). In all cases, statistically significant improvement was evidenced by the ARS and IKDC scales following AIAR (p = 0.00048), with excellent outcomes in 71% of the cases according to the ARS scale and in 86% according to the IKDC scale (mean difference of 11.9/16 and 33.8/100 points, respectively). No complications were recorded. Conclusion The AIAT technique is effective in allowing a return to previous sports performance levels in a short period of time among patients with ITBS refractory to conservative management, with a high satisfaction rate and the absence of complications.

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Section: Discussionmentioning

confidence: 99%

All-inside Arthroscopic Release for Iliotibial Band Syndrome. Description of Surgical Technique and Short-term Results

Arnal-Burró

Vidal-Fernández

Igualada-Blázquez

et al. 2022

Preprint

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“…14,30 There is an expansion of arthroscopic techniques reported to address ITBS, but they were excluded from our systematic review due to failure to report patient outcomes. [30][31][32] There is an expansion of arthroscopic techniques reported to address ITBS, but they were excluded from our systematic review due to failure to report patient outcomes [30][31][32] The comparison of the clinical outcomes and safety profile between open and arthroscopic surgical techniques to address ITBS is a subject of future investigation. In contrast to the group of studies reporting the outcomes following conservative management of ITBS, the return to sport rate, timing, and level of competition upon return was more consistently reported in studies that examined the effectiveness of surgical therapy.…”

Section: Discussionmentioning

confidence: 99%

Operative Versus Nonoperative Management of Distal Iliotibial Band Syndrome—Where Do We Stand? A Systematic Review

Bolia¹,

Gammons

Scholten

et al. 2020

Arthroscopy, Sports Medicine, and Rehabilitation

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Purpose: To systematically review the operative versus nonoperative methods for management of iliotibial band syndrome (ITBS) with comparison of the respective clinical outcomes. Methods: By adhering to the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines, 3 databases (Medline, Scopus, Web of Science) searched from inception to October 2019 for randomized clinical trials (RCTs) and observational studies on humans that reported the outcomes following operative or nonoperative management of ITBS. Excluded were case reports, case series with <5 participants, review articles, non-English articles, and nonepeer-reviewed articles. The Methodological Index for Non-Randomized Studies (MINORS) criteria for observational studies and the Cochrane Risk of Bias Tool for RCTs were used for quality control. Results: There were 15 eligible studies (9 for operative,6 for nonoperative treatment) examining 179 athletes (mean age 27.3 years, range: 17-53) who received conservative therapy for ITBS and 200 athletes (mean age 30.1 years, range: 14-63) who underwent surgical treatment. Most athletes were runners (65%). The mean follow-up time was significantly longer in studies reporting the outcomes following operative compared with nonoperative ITBS treatment (33.5 vs 2 months, respectively, P < .05). Significant variability in the methods used to assess the clinical outcomes precluded meta-analysis. The most commonly reported (7/9 studies, 77.7%) variable for postoperative evaluation in athletes was the return to sport rate (range: 81%-100%). Significant reduction in pain was consistently (6/6 studies,100%) found among the studies reporting the results of conservative ITBS treatment. The included RCTs were of good (1/5, 20%), fair (2/5, 40%), or poor (2/5, 40%) quality, whereas the average MINORS score was 7.4 (range: 3-13) for observational studies. The level of evidence ranged from Level II (6/15 studies) to IV (9/15 studies). Conclusions: Based on the current literature and at a maximum follow-up time of 6 months, conservative therapy can effectively reduce ITBS symptoms in athletes. Multiple surgical options exist for athletes who do not respond to nonoperative measures, with a reported return to sport rate between 81% and 100%. Level of Evidence: Systematic review of Level II and IV studies

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“…The disorder was formerly known as "runner's knee" because it was the most common cause of lateral knee pain in runners 3 , with an incidence of 1.6-14%. Interestingly, many sports including repetitive cyclic movements of the knee are known to lead to the same pain syndrome, including cycling (15-24%), soccer, tennis, and competitive rowing 1,4,5,6,7,8,9 . Inappropriate training and sudden changes in training schedules such as excessive increase in distance or hill running exacerbate the complaints 10 .…”

Section: Introductionmentioning

confidence: 99%

“…(i) As the name of the syndrome states, it was thought that repetitive friction of the ITB along the lateral femoral epicondyle would lead to an inflammatory response with oedema, and potential chronicity due to fibrosis, cicatrisation, neovascularization and -innervation 1,3,7,9,11,12,13 . (ii) Fairclough et al studied 15 cadavers and found a firm distal attachment of the ITB over the linea aspera, preventing its anteroposterior movement 14 .…”

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confidence: 99%

Outcome of lateral retinacular nerve transection combined with release for recalcitrant iliotibial band friction syndrome

KLOOS,

BELLEMANS

2023

Acta Orthop Belg

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In this retrospective study, a technique consisting in neurolysis of the lateral retinacular nerve combined with a partial release through elliptic excision of the iliotibial band (ITB) is evaluated for efficacy in recalcitrant ITB friction syndrome and compared with results from other techniques reported in literature. From April 2014 to December 2017, 21 patients suffering from recalcitrant ITB friction syndrome were surgically treated with the aforementioned technique. 15 patients (15 knees) were available for a written retrospective reassessment after completion of a follow-up period of at least 12 months. Residual pain was scored using the Visual Analogue Scale (VAS). The functional outcome was evaluated by two patient reported outcome measurement scales (PROMs), the Lysholm and the International Knee Documentation Committee (IKDC) score. Return to sport was analysed by duration of the inactivity period as well as by the Tegner score. Overall satisfaction was evaluated using a modified Boyden scale. At final follow-up of one year, the performed intervention resulted in a pain reduction (VAS 4.2 (1-8) to 1.4 (0-6)) and improved knee function (Lysholm 59.53 to 87.73, IKDC 75) with return to sport (Tegner 4.3 to 5.4) after a median of 23.8 weeks (6 to 52). Twelve patients reported good or excellent results (80%) at final follow-up, and 12 patients (80%) would undergo surgery again, if necessary. The treatment of recalcitrant ITB friction syndrome by combining neurectomy of the lateral retinacular nerve with elliptic excision of the ITB resulted in good to excellent results in 80% of treated cases with return to sport in 93%.

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Iliotibial Band Lengthening: An Arthroscopic Surgical Technique

Cited by 8 publications

References 19 publications

All-inside Arthroscopic Release for Iliotibial Band Syndrome. Description of Surgical Technique and Short-term Results

All-inside Arthroscopic Release for Iliotibial Band Syndrome. Description of Surgical Technique and Short-term Results

Operative Versus Nonoperative Management of Distal Iliotibial Band Syndrome—Where Do We Stand? A Systematic Review

Outcome of lateral retinacular nerve transection combined with release for recalcitrant iliotibial band friction syndrome

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