Intra-articular transfer of the iliotibial tract. Two to seven-year follow-up results.
A proximally based transfer of a composite structure of the iliotibial tract, its osseous insertion, the lateral retinaculum, and part of the vastus lateralis was used in 111 anterior cruciate-deficient knees that were followed for two to seven years. No other ligament procedures were performed simultaneously. The clinical results included a negative Lachman test in 81 per cent (ninety) of the knees, an anterior drawer test of 1+ or less in 84 per cent (ninety-three knees), and a negative pivot-shift sign in 94 per cent (104 knees). Subjectively, 74 per cent (eighty-two) of the knees were rated as excellent; 21 per cent (twenty-three), as good; and 5 per cent (six), as poor. A significant modification in surgical technique, consisting of a limited posterior dissection of the iliotibial band, yielded even better static stability than the original operation did. These results, sustained for as long as seven years, are consistent with the physiological aspects of this transfer. The surgical technique is reproducible and the immediate fixation of bone allows early motion of the knee and reasonable rehabilitation.