An anatomic study of the iliotibial tract.
ABSTRACT 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.
Ten detailed anatomic dissections were performed by using incisions as recommended by the literature in fresh cadaver knees identifying the iliotibial tract components.
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.
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.
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.
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ABSTRACT: A knowledge of the patterns of injury to the components of the iliotibial tract allows a clearer interpretation of motion limits testing in patients with abnormal anterior tibial translation of the knee (anterior cruciate ligament-deficient knees). Eighty-two consecutive patients with acute knee injuries were classified as anteromedial-anterolateral rotatory instability (anterior cruciate ligament-deficient) based on the abnormal motion demonstrated by clinical examination tests for instability. At surgery, injuries to the intraarticular and extraarticular anatomic structures were identified and correlated to the abnormal grades of motion demonstrated by the knee motion limits examination. Tears of the anterior cruciate ligament occurred in 80 (98%) of the knees. However, the grade of abnormal motion demonstrated by the Lachman and pivot shift tests was quite variable. This variation did not correlate statistically with anterior cruciate ligament tears. Injuries to the anatomic components of the iliotibial tract were confirmed in 76 (93%) of the knees. These injuries correlated highly with variations in grades of abnormal motion detected by the following tests: lateral joint line opening at 30 degrees (r2 = 0.05); Lachman test (r2 = 0.08); pivot shift (r2 = 0.16); and anterior translation at 90 degrees of flexion (r2 = 0.34). Thus, injuries to the components of the iliotibial tract are thought to contribute to the variation in grades of abnormal motion observed in this complex subgroup of anterior tibial translation instabilities.The American Journal of Sports Medicine 01/1993; 21(1):55-60. · 4.44 Impact Factor
Article: THE KNEE01/1999;