An anatomic study of the iliotibial tract.

PURPOSE: To identify the structure of the iliotibial tract at knee level, as well as its insertions, layer arrangement, and relationship with other structures of the lateral region of the knee and to compare the findings with available literature. METHODS: Ten detailed anatomic dissections were performed by using incisions as recommended by the literature in fresh cadaver knees identifying the iliotibial tract components. RESULTS: The authors observed an iliotibial tract arrangement in superficial, deep, and capsular-osseous layers. Insertions have been described as follows: at linea aspera, at the upper border of the lateral epicondyle, at the patella, and at Gerdy's tibial tuberculum and across the capsular-osseous layer. CONCLUSIONS: The iliotibial tract (ITT) has important interconnections to the femur, the patella, and the lateral tibia; the iliopatellar band joins the ITT to the patella through the superficial oblique retinaculum and the lateral femoropatellar ligament, and the ITT capsular-osseous layer presents differentiated fibers in an arched arrangement that borders the femoral condyle and inserts laterally to the Gerdy's tubercle. CLINICAL RELEVANCE: The iliotibial tract can be considered as an anterolateral knee stabilizer, particularly its capsular-osseous layer, which, together with the anterior cruciate ligament, constitutes a functional unit forming a spatial "horseshoe" form. The detailed description of the structures forming iliotibial tract plays an important role in the study of knee instabilities. Its important tibial, femoral, and patellar connections are described so that better understanding of tibial femoral instability on the lateral side as well as patellofemoral instability can be achieved and mechanisms of repair can be conceived.

Estudo anatomico do trato iliotibial: revisão crítica de sua importância na estabilidade do joelho / Anatomic study of the iliotibial tract: critical revision of its importance for knee stability

Os autores realizaram 10 dissecões anatomicas pormenorizadas em joelhos de cadáveres a fresco identificando os componentes do trato iliotibial e observaram sua disposição em camadas superficial, profunda e cápsulo-ossea. Foram observadas também suas inserçäes na linha áspera, na margem superior do epicondilo lateral, na patela, no tubérculo de Gerdy e através da camada cápsulo-¢ssea. Ap¢s a descrição desses componentes, relacionando com a literatura, os autores estabeleceram a importância do trato iliotibial como estabilizador ântero-lateral do joelho, especialmente da camada cápsulo-ossea, que, juntamente com o ligamento cruzado anterior, constitui uma unidade funcional formando uma figura espacial em ferradura. Este estudo permitiu maior compreensão da estabilização ântero-lateral do joelho, a gênese do sinal do ressalto e a contenção lateral da patela.