What is ITB Release?
ITB release is an operation that lengthens the iliotibial band (ITB). This is a strong fibrous band that runs down the outside of the leg and knee. The surgery is usually combined with arthroscopy surgery on the knee, and involves an extra incision on the outside of the knee just above the knee cap
How can ITB release help?
The ITB has strong attachments to the patella. Releasing the ITB can allow the patella to be more mobile. In patients with patella tracking problems this procedure may be combined with other surgery to make the patella track better.
In some patients, arthritis can develop between the knee cap and femur. In a select group of patients in whom non-operative treatment has not worked, releasing the ITB may decrease pain by decreasing the pressure on the patellofemoral joint
What sort of anaesthetic is used?
Almost all ITB release knee surgery is done on an outpatient basis with arrival at hospital an hour or two prior to surgery. Arthroscopy with ITB release can be performed under regional, or general anesthesia. Regional anesthesia numbs below the waist, and general anesthesia puts to sleep. The anesthetist will determine which is most suitable.
What should I expect after the ITB release?
Most patients experience only mild discomfort when they wake up after a knee arthroscopy and ITB release.
Recovery from surgery is much faster than recovery from traditional open knee surgery. Still, it is important to follow the instructions carefully and have someone check on you that evening.
The wounds will be dressed with waterproof dressings under the outer bandage. The outer bandage may be removed 24hrs after surgery. The smaller dressing is to remain intact for 7-10 days.
How Long will it take to recover?
Unless told otherwise, weight bearing on the leg (as comfort allows) is recommended immediately after the surgery. Crutches may be used for comfort where necessary, and are usually required for 2-3 days. Patients are usually walking reasonably comfortably by 2 weeks and by 6 weeks can generally commence running. It is important not to over-exert too early after the procedure as this can increase the discomfort and swelling. Gradual reintroduction of activities within levels of comfort is recommended. Drive a car is allowed the next day. People with desk jobs can return to work as early as 1-2 days, while people in more heavy manual employment may require 6 weeks.
Is physiotherapy required after ITB release?
Physiotherapy is commenced immediately post operatively. A physiotherapist will supervise muscle contractions, walking and weight bearing. Physiotherapy will continue on a daily basis following surgery until the dressings are removed 7-10 days following surgery. Sedentary and office workers may return to work approximately 2-3 days following surgery. Most patients should be walking normally 7 days following surgery although there is considerable patient to patient variation.
What are the risks?
Knee arthroscopy combined with ITB release is a very safe procedure. The most common side effect is temporary discomfort or slight bruising. Potential postoperative problems with ITB release include infection, blood clots, and an accumulation of blood in the knee. These occur infrequently.
As with all operations if at any stage anything seems amiss it is better to call up for advice rather than wait and worry. A fever, or redness or swelling around the line of the wound, an unexplained increase in pain should all be brought to the attention of the surgeon.