title: Treatment of recalcitrant iliotibial band friction syndrome with open iliotibial band bursectomy: indications, technique, and clinical outcomes.
abstract: BACKGROUND
  Iliotibial band friction syndrome (ITBFS) is an overuse injury causing lateral knee pain. There is evidence that the pathological lesion is in fact an inflamed bursa underlying the iliotibial band (ITB) rather than an inflamed ITB itself.
  
  
  OBJECTIVE
  Resection of the bursa underlying the ITB in ITBFS patients will relieve their pain and allow them to return to their preinjury activity level.
  
  
  METHODS
  Case series; Level of evidence, 4.
  
  
  METHODS
  We describe the technique of ITB bursectomy and report a minimal 20-month follow-up of patients who had ITB bursectomies performed by a single surgeon. The patients completed a survey detailing their preoperative and postoperative symptoms and activities.
  
  
  RESULTS
  The senior author performed 12 consecutive cases of ITB bursectomies (12 patients). One was excluded from the study (previous microfracture). The average age at surgery was 32 years (standard deviation, 5; range, 24-41). There were 7 men and 4 women. Postoperatively, patients were able to return to their preinjury Tegner activity levels, and the visual analog pain scores decreased by an average of 6 points (P < .001). Six patients were completely satisfied with the surgical outcome, 3 were mostly satisfied, 2 were somewhat satisfied, and none were dissatisfied. Nine of 11 patients said that knowing what they know now, they would have the surgery performed again for the same problem.
  
  
  CONCLUSIONS
  Iliotibial band bursectomy successfully reduces knee pain in patients with ITBFS and allows them to return to their preinjury level of activity. The great majority of patients were satisfied with the results of the procedure.
authors.affiliation: Division of Sports Medicine, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts 02114-2696, USA. sanaz@post.harvard.edu
authors.forename: Sanaz
authors.initials: S
authors.lastname: Hariri
authors.forename: Edgar T
authors.initials: ET
authors.lastname: Savidge
authors.forename: Michael M
authors.initials: MM
authors.lastname: Reinold
authors.forename: James
authors.initials: J
authors.lastname: Zachazewski
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Gill
mesh_terms: D000328:Adult; D001265:Athletic Injuries; D002062:Bursitis / Q000473:pathology / Q000601:surgery*; D012090:Cumulative Trauma Disorders / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D006306:Health Surveys; D006801:Humans; D007718:Knee Injuries / Q000175:diagnosis / Q000601:surgery; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D010146:Pain / Q000473:pathology; D013577:Syndrome; D055815:Young Adult