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Ultrasound-Guided Cutting Wire Release of the Posterior Iliotibial Band: A Feasibility Study.
PM R. 2020 Feb 07 [Online ahead of print]PM R

Abstract

BACKGROUND

Distal iliotibial band friction syndrome (ITBFS) is a common cause of knee pain in endurance athletes. Nonsurgical treatment is usually successful, but surgery is occasionally required for recalcitrant cases. No published studies to date have evaluated the feasibility of an ultrasound-guided (USG) partial iliotibial band (ITB) release.

OBJECTIVE

To determine the feasibility of an USG partial ITB release using a cutting wire. A secondary aim was to assess whether adjacent structures were damaged. We hypothesized that the posterior distal ITB could be partially transected with a cutting wire under USG with no injury to adjacent structures.

DESIGN

Cadaveric study.

SETTING

Quaternary-care academic institute.

PARTICIPANTS

Ten cadaveric knees ranging from 76-89 years old with a mean body mass index of 21.9 kg/m2 .

INTERVENTIONS

One physician sonographer performed USG releases of the posterior ITBs at the level of the lateral femoral epicondyle with a cutting wire. Dissection was carried out by an independent second physician to assess for primary and secondary outcomes.

MAIN OUTCOME MEASURES

(1) Release of the posterior border of the ITB; (2) width of the release; (3) evaluation for any injury to adjacent structures; (4) technical difficulty of the procedure (0 = no difficulty, 10 = most difficult procedure possible); (5) duration of time it took to complete the procedure.

RESULTS

All 10 knees had the posterior border of the ITB transected. Mean release length was 16 mm (range 15-17), which was within 1 mm of the target release length of 15 mm. No adjacent structures were damaged.

CONCLUSION

A USG release of the posterior ITB utilizing a cutting wire is feasible and safe in a cadaveric model. Translational research is warranted to determine how these results apply to the clinical setting.

Authors+Show Affiliations

Summit Orthopedics, Sports Medicine, Eagan, MN.Department of Physical Medicine and Rehabilitation, Mayo Clinic College of Medicine and Science, Rochester, MN.Department of Orthopedic Surgery, Mayo Clinic College of Medicine and Science, Rochester, MN.Department of Physical Medicine and Rehabilitation, Mayo Clinic College of Medicine and Science, Rochester, MN.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32030905

Citation

Boettcher, Brennan J., et al. "Ultrasound-Guided Cutting Wire Release of the Posterior Iliotibial Band: a Feasibility Study." PM & R : the Journal of Injury, Function, and Rehabilitation, 2020.
Boettcher BJ, Hollman JH, Stuart MJ, et al. Ultrasound-Guided Cutting Wire Release of the Posterior Iliotibial Band: A Feasibility Study. PM R. 2020.
Boettcher, B. J., Hollman, J. H., Stuart, M. J., & Finnoff, J. T. (2020). Ultrasound-Guided Cutting Wire Release of the Posterior Iliotibial Band: A Feasibility Study. PM & R : the Journal of Injury, Function, and Rehabilitation. https://doi.org/10.1002/pmrj.12340
Boettcher BJ, et al. Ultrasound-Guided Cutting Wire Release of the Posterior Iliotibial Band: a Feasibility Study. PM R. 2020 Feb 7; PubMed PMID: 32030905.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ultrasound-Guided Cutting Wire Release of the Posterior Iliotibial Band: A Feasibility Study. AU - Boettcher,Brennan J, AU - Hollman,John H, AU - Stuart,Michael J, AU - Finnoff,Jonathan T, Y1 - 2020/02/07/ PY - 2019/10/21/received PY - 2020/01/21/revised PY - 2020/01/27/accepted PY - 2020/2/8/pubmed PY - 2020/2/8/medline PY - 2020/2/8/entrez JF - PM & R : the journal of injury, function, and rehabilitation JO - PM R N2 - BACKGROUND: Distal iliotibial band friction syndrome (ITBFS) is a common cause of knee pain in endurance athletes. Nonsurgical treatment is usually successful, but surgery is occasionally required for recalcitrant cases. No published studies to date have evaluated the feasibility of an ultrasound-guided (USG) partial iliotibial band (ITB) release. OBJECTIVE: To determine the feasibility of an USG partial ITB release using a cutting wire. A secondary aim was to assess whether adjacent structures were damaged. We hypothesized that the posterior distal ITB could be partially transected with a cutting wire under USG with no injury to adjacent structures. DESIGN: Cadaveric study. SETTING: Quaternary-care academic institute. PARTICIPANTS: Ten cadaveric knees ranging from 76-89 years old with a mean body mass index of 21.9 kg/m2 . INTERVENTIONS: One physician sonographer performed USG releases of the posterior ITBs at the level of the lateral femoral epicondyle with a cutting wire. Dissection was carried out by an independent second physician to assess for primary and secondary outcomes. MAIN OUTCOME MEASURES: (1) Release of the posterior border of the ITB; (2) width of the release; (3) evaluation for any injury to adjacent structures; (4) technical difficulty of the procedure (0 = no difficulty, 10 = most difficult procedure possible); (5) duration of time it took to complete the procedure. RESULTS: All 10 knees had the posterior border of the ITB transected. Mean release length was 16 mm (range 15-17), which was within 1 mm of the target release length of 15 mm. No adjacent structures were damaged. CONCLUSION: A USG release of the posterior ITB utilizing a cutting wire is feasible and safe in a cadaveric model. Translational research is warranted to determine how these results apply to the clinical setting. SN - 1934-1563 UR - https://www.unboundmedicine.com/medline/citation/32030905/Ultrasound-Guided_Cutting_Wire_Release_of_the_Posterior_Iliotibial_Band:_A_Feasibility_Study L2 - https://doi.org/10.1002/pmrj.12340 DB - PRIME DP - Unbound Medicine ER -
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