Avanfi Institute and Unit for Ultrasound-guided Surgery, Hospital Beata María Ana, Madrid, Spain.
Avanfi Institute and Unit for Ultrasound-guided Surgery, Hospital Beata María Ana, Madrid, Spain.
Knee. 2021 Jun;30:9-17. doi: 10.1016/j.knee.2021.02.021. Epub 2021 Mar 27.
Iliotibial band (ITB) syndrome is the most common cause of lateral knee pain in runners (affecting 7-14%) and in persons taking part in other sports. The aim of this study was to show how to perform a distal release of the ITB guided by ultrasound and present our initial results with this new technique.
The surgical technique - either Z-plasty or transverse section of the ITB - was first validated on 14 cadaver specimens and then applied in clinical practice. We operated on 32 patients (27 males and five females, 34 cases) from 2013 to 2018. Mean age was 40 years (25-60). The patients comprised 21 recreational middle- or long-distance runners (23 cases), five cyclists, two basketball players, two military personnel, one fireman, and one boxer.
All patients were satisfied after 3 months and returned to their sporting activities without restrictions. The visual analog scale score for the practice of sports activities improved from 7 (6-9) before surgery to 0 (0-1) after. The average Lysholm score was 68 points before surgery and 97 (91-100) after, with five good results and 29 excellent results. No patients complained of instability or muscle weakness after 3 months.
Ultrasound-guided release of the ITB is a novel minimally aggressive surgical approach that potentially enables faster recovery. It is relatively easy, quick, and painless, with a small incision, and can be performed under local anaesthesia in an outpatient setting. It does not require limb exsanguination or stitches, and complications are minimal.
髂胫束（ITB）综合征是跑步者（影响 7-14%）和参与其他运动的人出现外侧膝关节疼痛的最常见原因。本研究旨在展示如何在超声引导下进行 ITB 的远端松解，并展示我们使用这种新技术的初步结果。
手术技术——Z 成形术或 ITB 横断——首先在 14 具尸体标本上进行验证，然后在临床实践中应用。我们在 2013 年至 2018 年间对 32 名患者（27 名男性和 5 名女性，34 例）进行了手术。平均年龄为 40 岁（25-60 岁）。患者包括 21 名休闲中长跑运动员（23 例）、5 名自行车运动员、2 名篮球运动员、2 名军人、1 名消防员和 1 名拳击手。
所有患者在术后 3 个月均满意，且无限制地恢复运动。体育活动实践的视觉模拟评分从术前的 7 分（6-9 分）改善至术后的 0 分（0-1 分）。术前平均 Lysholm 评分为 68 分，术后为 97 分（91-100 分），其中 5 例结果良好，29 例结果优秀。术后 3 个月无患者抱怨不稳定或肌肉无力。
超声引导下 ITB 松解是一种新颖的微创侵袭性手术方法，可能会加速康复。它相对简单、快速、无痛，切口小，可在局麻下于门诊环境中进行。它不需要肢体放血或缝合，并发症极少。
