Síndrome de la banda iliotibial / Iliotibial band syndrome

Introducción: El dolor en la rodilla responde a múltiples causas. Entre ellas se encuentra el síndrome de la banda iliotibial que afecta, principalmente, a pacientes jóvenes que practican cierta actividad deportiva. Objetivo: Actualizar y ofrecer información sobre el síndrome de la banda iliotibial. Métodos: La búsqueda y análisis de la información se realizó en un periodo de 92 días (01 de julio al 30 de septiembre de 2020). Se emplearon las siguientes palabras: iliotibial band syndrome, iliotibial band friction syndrome AND lateral knee pain. Se realizó una revisión bibliográfica de un total de 186 artículos publicados en las bases de datos PubMed, Hinari, SciELO y Medline mediante el gestor de búsqueda y administrador de referencias EndNote, de ellos se utilizaron 40 citas seleccionadas para realizar la revisión, 38 de los últimos cinco años. Desarrollo: Se mencionan las características anatómicas más importantes relacionadas con la banda iliotibial. Se refiere a las maniobras empleadas, así como los exámenes imagenológicos de mayor utilidad. Se exponen las principales entidades implicadas en el diagnóstico diferencial. Con relación al tratamiento se mencionan las modalidades conservadoras y quirúrgicas. Conclusiones: El síndrome de la banda iliotibial es una enfermedad que tiene como característica fundamental dolor lateral de la rodilla el cual aumenta con la actividad física. El tratamiento conservador constituye la primera línea y el quirúrgico está justificado a los seis meses de respuesta limitada a la primera modalidad del enfrentamiento terapéutico(AU)

Introduction: Knee pain responds to multiple causes such as the iliotibial band syndrome that mainly affects young patients who practice certain sports activities. Objective: To update and offer information on iliotibial band syndrome. Methods: The search and analysis of the information was carried out in a period of 92 days - from July 1 to September 30, 2020, with the words iliotibial band syndrome, iliotibial band friction syndrome AND lateral knee pain. A bibliographic review of 186 articles published in PubMed, Hinari, SciELO and Medline databases was carried out using the EndNote search manager and reference manager, Forty citations were selected to perform the review, 38 of them were from the last five years. Development: The most important anatomical characteristics related to the iliotibial band are mentioned. They refer to the maneuvers used, as well as the most useful imaging tests. The main entities involved in the differential diagnosis are presented. Regarding treatment, conservative and surgical modalities are mentioned. Conclusions: The iliotibial band syndrome is a disease, main characterized by lateral knee pain, which increases with physical activity. Conservative treatment constitutes the first option; in addition, surgical treatment is justified after six months of limited response to the first option of therapeutic management(AU)

Outcome of Low-Invasive Local Split-Thickness Lengthening for Iliotibial Band Friction Syndrome.

Conventional surgical methods for iliotibial band friction syndrome (ITBFS) may affect the iliotibial band (ITB), delaying return to sports activities or impeding performance. We have developed a minimally invasive method. This study retrospectively analyzed the outcomes of this procedure in individuals with ITBFS. This study included 34 knees of 31 individuals. Surgery involved lengthening the central part of the ITB by splitting it into a superficial and a deep layer, maintaining the anterior and posterior fibers immediately above the lateral epicondyle. Outcomes included time to resume sports activity, personal best times to run a 5000-m race before and after surgery, and 2-month post-surgery muscle strengths. The mean postoperative time to return to competition was 5.8 weeks. Personal best times of 5000-m race improved in 13 of 17 runners. Two months post-surgery, the mean extensor muscle strengths on the healthy and affected sides did not significantly differ nor did the flexor muscle strengths. In ITBFS, the ITB itself is normal. Lengthening the limited region of the ITB immediately above the lateral femoral epicondyle removes the cause of ITBFS, with a reduction in inflammation. This technique resulted in early return to competition without degrading performance.

Ultrasound-Guided Knee Procedures.

Most knee structures can be accurately targeted using ultrasound guidance. These structures are usually superficial, and the overlying soft tissues are mobile and compressible, facilitating excellent visualization with a high-frequency linear array transducer. The circumferential accessibility to the knee affords flexibility and often multiple procedural approach options. In most cases, an in-plane approach is easily achieved. Studies of ultrasonography-guided knee procedures have consistently shown high accuracy, and its use is particularly beneficial for obese patients, diagnostic injection specificity, safety, and precise targeting of pathology. More studies are needed to assess the clinical efficacy and cost-effectiveness of ultrasonography-guided knee procedures.

Sonographic measurement of iliotibial band thickness: an observational study in healthy adult volunteers.

PURPOSE: Iliotibial tract friction syndrome (ITBFS) might be caused by repetitive friction and abrasion of the iliotibial (ITB) tract across the lateral femoral epicondyle. Thickening in the ITB adjacent to the lateral femoral epicondyle has been reported. The values of ITB thickness at the lateral femoral epicondyle in healthy adult volunteers were determined, and the association between the thickness of the ITB and the subjects' age, weight, height, dominant limb and the volume of training or sporting activity was assessed. METHODS: An Ultrasound Scan (high resolution 3-2 MHz transducer Voluson-i G E Medical Systems, UK) was used to measure the thickness of the ITB in 38 healthy volunteers (30 men and 8 women, mean age 22.5 ± 1.5 years, range 18-25 years). One measurement from each of the subjects' knees at the level of lateral femoral epicondyle was taken. Reliability was established by measuring 11 of the subjects on three separate occasions at least I week apart. RESULTS: The thickness of the ITB on the right and left knees was 1.1 ± 0.2 mm. There was no evidence of a significant association between the thickness of the ITB and the subjects' age, weight, height, dominant limb and the volume of training or sporting activity. CONCLUSIONS: There is no evidence of significant correlation between the thickness of the ITB and subjects' age, weight, height, dominant limb and volume of training or sporting activity.