Lengthening of the iliotibial band by femoral detachment and multiple puncture

Zenz, Peter; Huber, Monika; Obenaus, Christian; Schwägerl, W

doi:10.1007/s00402-002-0419-2

Cited by 10 publications

(4 citation statements)

References 3 publications

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“…In some cases of TKA for valgus knees, contracture of ITB is of great significance and variety of different techniques including distal detachment, Z-plasty, or multiple puncture have been proposed for lengthening the ITB. 15 Multiple puncturing techniques have been applied to this particular case which released the tightened ITB.…”

Section: Discussionmentioning

confidence: 99%

Snapping Phenomenon after Revisional Total Knee Arthroplasty

Yang

Yoon

2018

IJOO

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The cases of revision total knee arthroplasty (TKA) are increasing. In this report, snapping phenomenon after final implantation of revision TKA has been presented. Snapping was caused by adhered iliotibial band (ITB) impinging against the lateral part of femoral component. Fractional lengthening the ITB by puncture resolved the snapping phenomenon. Surgeons should be aware of the presence of such a case which should be identified during operation to avoid secondary operations.

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Section: Discussionmentioning

confidence: 99%

Snapping Phenomenon after Revisional Total Knee Arthroplasty

Yang

Yoon

2018

IJOO

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“…Fascia lata and the ilio-tibial band are the main deforming forces in the flexion and valgus deformity, and the ITB with hamstring contracture contributes to the posterior subluxation of the tibia. The contracted ITB may be released by transverse section above the joint line 28 or by sub-periosteal elevation from the Gerdy's tubercle, or modulated, by section of the Kaplan fibres by Z or VY plasty and "pie crusting". 29 It is believed that the pie-crust is a reliable technique to correct moderate to severe fixed valgus deformed knees with excellent results and limited complications, 29,30 but few studies report this technique of lateral release, justified only in severe valgus deformities that require constrained prosthesis as in the one we have described.…”

Section: Discussionmentioning

confidence: 99%

Concurrent femoral and tibial osteotomies versus soft tissue balance in total knee arthroplasty: A technical case report

Presti

Costa

Cialdella

et al. 2017

Journal of Orthopaedics

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This case report outlines some of the challenges as well as limitations in correction of osteoarthritis of the knee in combination with extra-articular deformities,and provides a novel and straightforward surgical solution in overcoming these challenges. We describe the case of a 37-year-old male who suffered from advanced bilateral tri-compartmental knee arthritis due to untreated bloodstream-sourced osteomyelitis after birth. Radiographs and surgery confirmed extremely severe deformities. We performed two different surgical techniques in order to correct extra-articular deformities (one-stage approach of concurrent tibial and femoral osteotomy and total knee arthroplasty on one side, and soft tissue balancing with "pie-crusting technique" plus total knee arthroplasty on the other side), with description of subsequent results at 36-months follow-up.

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“…This along-with erosion of the posterior aspect of the femoral condyles, and quadriceps weakness leads to a peculiar drum stick appearance of the limb. The contracted ITB may be released by transverse section above the joint line 4 or by sub-periosteal elevation from the Gerdy's tubercle, or modulated, by section of the Kaplan fibres by Z or VY plasty and "pie crusting". 5 However isolated fascia lata release proves sufficient only in small deviations.…”

Section: Discussionmentioning

confidence: 99%

Total knee replacement in triple deformity with posterior subluxation of the knee joint

Lal

Sabharwal

Tanwar

2015

Journal of Clinical Orthopaedics and Trauma

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Total knee replacement a b s t r a c tDislocation or subluxation following total knee arthroplasty has been extensively reported, but vice versa that is total knee replacement for subluxed or dislocated knee has not been published. Triple deformity of knee that is flexion, external rotation, valgus at knee associated with posterior subluxation of tibia occurs in rheumatoid arthritis, advanced tubercular arthritis and neglected posttraumatic residual dislocated knee. A 50 year old female with seropositive rheumatoid arthritis had the above disabling deformity in left lower limb and varus with medial tibial thrust in the other. Bilateral total knee arthroplasty was planned. Conservative method of reduction of left knee posterior subluxation preoperatively by 90-90 skeletal traction failed; hence patient was subjected to a staged bilateral total knee replacement using an innovative technique. The most difficult and determining initial surgical step of knee replacement in such dislocated/subluxed knee is reduction of posterior subluxation and gaining flexion at knee, as only after gaining flexion and reducing dislocated tibia, will we be able to do knee arthroplasty in triple deformity of knee.These knees are grossly unstable as most of the capsule-ligamentous structures are attritioned/non-existent. So, a fine balance of bone cuts and soft-tissue release needs to be done in a sequential manner to fine tune valgus and posterior subluxation correction without jeoparadising neurovascular structures. After 3 years of knee arthroplasty the patient has painless, stable knee with good range of motion and is able to do all her activities, of living in a hilly terrain.

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Lengthening of the iliotibial band by femoral detachment and multiple puncture

Abstract: The results show that a sufficient release of the iliotibial band can be achieved with the techniques except for severe cases of valgus deformation, where more effective methods to release the iliotibial band such as Z-plasty or complete dissection should be performed.

Cited by 10 publications

References 3 publications

Snapping Phenomenon after Revisional Total Knee Arthroplasty

Snapping Phenomenon after Revisional Total Knee Arthroplasty

Concurrent femoral and tibial osteotomies versus soft tissue balance in total knee arthroplasty: A technical case report

Total knee replacement in triple deformity with posterior subluxation of the knee joint

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