Title: Iliotibial band traction syndrome in guided motion TKA. A new clinical entity after TKA
Authors: Luyckx, Lucas ×
Luyckx, Thomas
Bellemans, Johan
Victor, Jan #
Issue Date: Aug-2010
Publisher: Acta Medica Belgica
Series Title: Acta Orthopaedica Belgica vol:76 issue:4 pages:507-512
Abstract: This study aimed at systematic documentation of
lateral knee pain in a consecutive series of 1102 cruciate-
substituting, guided motion total knee arthroplasties
(TKA) (Journey®, Smith and Nephew,
Memphis, TN, USA) performed in 1085 patients ;
1070 knees were available for review. Follow-up time
ranged from one to five years, with a mean of
2.5 years. Symptoms mimicking the well known ilio -
tibial band (ITB) friction syndrome were observed in
77 knees (7.2%). Initial conservative treatment consisted
of anti-inflammatory medication (77 knees)
and local steroid injection (35 knees). The pain persisted
in 22 knees (2%), leading to a surgical release
of the iliotibial band. Other surgical interventions
included revision for infection (6 knees, 0.5%), revision
for tibial component loosening (6 knees, 0.5%),
revision for tibiofemoral dislocation (3 knees, 0.3%),
revision for patellar component loosening (5 knees,
0.4%), revision for instability (1 knee, 0.1%) and
secondary patellar resurfacing (1 knee, 0.1%). The
overall survivorship with partial or total implant
revision as an endpoint was 98%. The development of
lateral knee pain in association with the use of a
guided motion design can be explained by the forced
posterior translation of the lateral condyle in flexion.
The asymmetric cam and post mechanism, acting as
a hard driver of posterior femoral translation and
internal tibial rotation during flexion, does not allow
for the natural kinematic variability occurring in
native knees. This repetitive and forced stretching of
the ITB seems to induce a painful traction syndrome
in some patients.
ISSN: 0001-6462
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Orthopaedics Section (-)
× corresponding author
# (joint) last author

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