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THE ILIOTIBIAL BAND WITH ITS FEMORAL ATTACHMENTS AT THE KNEE…

55

BIOMECHANICAL STUDIES

OF LATERAL SOFT TISSUES

In our lab at Imperial College, London, a

classic cutting study using a 6-degree-of-

freedom robot was undertaken [9]. Sequentially

structures were sectioned and the same motion

was replayed by the robot, whilst measuring

the resistance to movement. In this way the

percentage contribution to resisting certain

movements could be calculated for the

structures that had been cut. This was

undertaken with the knee at straight, 30, 60 and

90 degrees. As one would expect, throughout

the range of motion tested the anterior cruciate

ligament is the primary restraint to anterior

tibial translation.

Fig. 2:

Lateral soft tissues exposed by refection

of ITB.

Lateral aspect of a left knee: the femur extends

proximally to the right, and the tibia extends

distally toward the bottom left with the patella at

the top left:

1

), Superficial layer of the iliotibial tract

(ITT) flapped down;

2

) proximal femoral insertion of

the ITT;

3

) supracondylar insertion of the ITT;

4

) retrograde insertion or capsulo-osseous layer;

5

) superior genicular artery;

6

) lateral collateral

ligament;

7

) fibular head;

8

) Gerdy tubercle; and

9

) intermuscular septum.

(Courtesy of Am J of

Sports Med)

.

Fig. 3:

Contribution of tested structures in restraining 90-N anterior tibial translation at 0°, 30°, 60°, and 90°

of flexion. Crosshatched areas indicate results from the ACL-deficient group. Shown as mean + SD; n=8.

Statistically significant change from the initial knee state (brackets indicate significant difference between

ACL intact

vs

deficient): *

P

<.05, **

P

<.01, and ***

P

<.001.

ACL

, anterior cruciate ligament;

ALL

, anterolateral

ligament;

Cap

, anterolateral capsule;

dcITT

, deep and capsulo-osseous layer of the iliotibial tract;

sITT

,

superficial layer of the iliotibial tract.

(Courtesy of Am J of Sports Med)

.