Iliotibial Band Pathology: Synthesizing the Available Evidence for Clinical Progress.

Area of Science:

• Orthopedics
• Sports Medicine
• Biomechanics

Background:

• The prevailing concept of iliotibial band friction syndrome (ITBFS) for lateral knee pain has been prevalent since 1974.
• Renne's original model for ITB pain was based on incomplete anatomical and biomechanical understanding, leading to ineffective treatments.
• Current evidence challenges the long-held paradigm of ITBFS.

Purpose of the Study:

• To deconstruct the traditional understanding of iliotibial band (ITB) related pathology.
• To synthesize mounting evidence from various studies to propose an updated model.
• To present a new paradigm for understanding and treating insidious onset ITB related pathology.

Main Methods:

• Review of arthroscopic, cadaveric, and biomechanical studies.
• Analysis of diagnostic imaging and histology reports.
• An evidence-based synthesis approach, likened to an archeological method.

Main Results:

• Evidence suggests the original ITBFS model is flawed.
• A comprehensive review of data supports a revised understanding of ITB pathology.
• The synthesis of evidence leads to a new conceptual framework.

Conclusions:

• The term 'iliotibial band friction syndrome' is inaccurate for describing lateral knee pain.
• A new paradigm, 'Iliotibial Band Impingement Syndrome,' offers a more informed approach.
• This updated model aims to improve the understanding and treatment of ITB-related knee pain.