A three-experiment examination of iliotibial band strain characteristics during different conditions using musculoskeletal simulation

Background: The Kaplan fibers (KFs) of the iliotibial band have been suggested to play a role in anterolateral rotational instability of the knee, particularly in the setting of an anterior cruciate ligament (ACL) rupture. Description of the normal magnetic resonance imaging (MRI) anatomy of the KFs may facilitate subsequent investigation into the MRI signs of injury. Purpose: To assess if the KF complex can be identified on 3-T MRI using standard knee protocols. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: 3-T MRI scans of 50 ACL-intact knees were reviewed independently by a musculoskeletal radiologist and 2 orthopaedic surgeons. Identification of the KFs was based on radiological diagnostic criteria developed a priori. Identification of the KFs in the sagittal, coronal, and axial planes was recorded. Interobserver reliability was assessed using the Kappa statistic. Detailed anatomy including distance to the joint line and relationship to adjacent structures was recorded. Results: The mean patient age was 43 years (range, 15-81 years), 58% were male, and 50% were right knees. The KFs were identified by at least 2 reviewers on the sagittal images in 96% of cases, on the axial images in 76% of cases, and on the coronal images in 4% of cases. The mean distance from the KF distal femoral insertion to the lateral joint line was 50.1 mm (SD, 6.6 mm) and the mean distance to the lateral gastrocnemius tendon origin was 10.8 mm (SD, 8.6 mm). The KFs were consistently identified immediately anterior to the superior lateral geniculate artery on sagittal imaging. Interobserver reliability for identification was best in the sagittal plane (Kappa 0.5) and worst in the coronal plane (Kappa 0.1). Conclusion: The KF complex can be identified on routine MRI sequences in the ACL-intact knee; however, there is low to moderate interobserver reliability. Imaging in the sagittal plane had the highest rate of identification and the coronal plane the lowest. There is a consistent relationship between the most distal KF femoral attachment and the lateral joint line, lateral gastrocnemius tendon, and superior lateral geniculate artery.

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Iliotibial band enthesopathy: an unusual cause of lateral knee pain post total knee replacement

Journal of Ultrasound ◽

10.1007/s40477-021-00565-z ◽

2021 ◽

Author(s):

G. Hegde ◽

A. Subramanian ◽

C. Azzopardi ◽

A. Patel ◽

S. L. James ◽

...

Keyword(s):

Total Knee Replacement ◽

Knee Pain ◽

Knee Replacement ◽

Iliotibial Band ◽

Total Knee ◽

Lateral Knee Pain

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Tenderness of the Skin after Chemical Stimulation of Underlying Temporal and Thoracolumbar Fasciae Reveals Somatosensory Crosstalk between Superficial and Deep Tissues

Life ◽

10.3390/life11050370 ◽

2021 ◽

Vol 11 (5) ◽

pp. 370

Author(s):

Walter Magerl ◽

Emanuela Thalacker ◽

Simon Vogel ◽

Robert Schleip ◽

Thomas Klein ◽

...

Keyword(s):

Electrical Stimulation ◽

Hypertonic Saline ◽

Detection Threshold ◽

Constant Current ◽

Iliotibial Band ◽

Deep Tissue ◽

Test Parameter ◽

Temporal Fascia ◽

Sufficient Stimulus ◽

Stimulation Of

Musculoskeletal pain is often associated with pain referred to adjacent areas or skin. So far, no study has analyzed the somatosensory changes of the skin after the stimulation of different underlying fasciae. The current study aimed to investigate heterotopic somatosensory crosstalk between deep tissue (muscle or fascia) and superficial tissue (skin) using two established models of deep tissue pain (namely focal high frequency electrical stimulation (HFS) (100 pulses of constant current electrical stimulation at 10× detection threshold) or the injection of hypertonic saline in stimulus locations as verified using ultrasound). In a methodological pilot experiment in the TLF, different injection volumes of hypertonic saline (50–800 µL) revealed that small injection volumes were most suitable, as they elicited sufficient pain but avoided the complication of the numbing pinprick sensitivity encountered after the injection of a very large volume (800 µL), particularly following muscle injections. The testing of fascia at different body sites revealed that 100 µL of hypertonic saline in the temporal fascia and TLF elicited significant pinprick hyperalgesia in the overlying skin (–26.2% and –23.5% adjusted threshold reduction, p < 0.001 and p < 0.05, respectively), but not the trapezius fascia or iliotibial band. Notably, both estimates of hyperalgesia were significantly correlated (r = 0.61, p < 0.005). Comprehensive somatosensory testing (DFNS standard) revealed that no test parameter was changed significantly following electrical HFS. The experiments demonstrated that fascia stimulation at a sufficient stimulus intensity elicited significant across-tissue facilitation to pinprick stimulation (referred hyperalgesia), a hallmark sign of nociceptive central sensitization.

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Ultrasound‐Guided Cutting Wire Release of the Posterior Iliotibial Band: A Feasibility Study

PM&R ◽

10.1002/pmrj.12340 ◽

2020 ◽

Vol 12 (11) ◽

pp. 1113-1119

Author(s):

Brennan J. Boettcher ◽

John H. Hollman ◽

Michael J. Stuart ◽

Jonathan T. Finnoff

Keyword(s):

Feasibility Study ◽

Iliotibial Band ◽

Ultrasound Guided

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Bilateral gluteus maximus contracture due to intra muscular injections

Tropical Doctor ◽

10.1177/0049475520984747 ◽

2021 ◽

pp. 004947552098474

Author(s):

Ravi Mittal ◽

Siddharth Jain

Keyword(s):

Gluteus Maximus ◽

Gluteal Region ◽

Iliotibial Band ◽

Intramuscular Injections ◽

Surgical Release

Gluteus maximus contracture, characterised by contracture of gluteus maximus, iliotibial band and covering fascia, can be caused by repeated intramuscular injections in the gluteal region. It is amenable to open surgical release.

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Iliotibial Band Autograft Provides the Fastest Recovery of Knee Extensor Mechanism Function in Pediatric Anterior Cruciate Ligament Reconstruction

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18147492 ◽

2021 ◽

Vol 18 (14) ◽

pp. 7492

Author(s):

Tishya L. Wren ◽

Veronica Beltran ◽

Mia J. Katzel ◽

Adriana S. Conrad-Forrest ◽

Curtis D. VandenBerg

Keyword(s):

Knee Flexion ◽

Ligament Reconstruction ◽

Cruciate Ligament ◽

Knee Extensor ◽

Extensor Mechanism ◽

Iliotibial Band ◽

Cruciate Ligament Reconstruction ◽

Mechanism Function ◽

Anterior Cruciate ◽

Knee Extensor Mechanism

Iliotibial band autograft is an increasingly popular option for pediatric anterior cruciate ligament reconstruction (ACLR). The purpose of this study was to compare recovery of knee extensor mechanism function among pediatric patients who underwent ACLR using iliotibial band (IT), hamstring tendon (HT), quadriceps tendon (QT), and patellar tendon (PT) autografts. One hundred forty-five pediatric athletes (76 female; age 15.0, range 7–21 years) with recent (3–18 months) unilateral ACLR performed drop-jump landing and 45° cutting with 3D motion capture. Knee extensor mechanism function (maximum knee flexion angle, maximum internal knee extensor moment, energy absorption at knee) during the loading phase (foot contact to peak knee flexion) was compared among graft types (20 IT, 29 HT, 39 QT, 57 PT) and sides (ACLR or contralateral) using linear mixed models with sex, age, and time since surgery as covariates. Overall, knee flexion was significantly lower on the operated vs. contralateral side for HT, QT, and PT during both tasks (p < 0.03). All graft types exhibited lower knee extensor moments and energy absorption on the operated side during both movements (p ≤ 0.001). Kinetic asymmetry was significantly lower for IT compared with QT and PT during both movements (p ≤ 0.005), and similar patterns were observed for HT vs. QT and PT (p ≤ 0.07). Asymmetry was similar between IT and HT and between QT and PT. This study found that knee extensor mechanism function recovers fastest in pediatric ACLR patients with IT autografts, followed by HT, in comparison to QT and PT, suggesting that IT is a viable option for returning young athletes to play after ACLR.

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