Background: Lengthening of the iliotibial band by various methods such as distal detachment, Z-plasty, or multiple puncture are common procedures for balancing the contracted valgus knee in total knee arthroplasty. This study was performed to measure the lengthening effect of multiple puncture and release of the distal femoral attachment of the iliotibial tract.
Methods: In a cadaver study on 14 knees, we studied the possible elongation of the iliotibial band by distal femoral detachment (release of Kaplan's fibers) and multiple puncture of the distal half of the tract. Maximum elongation was measured under a constant tension of 60 N.
Results: The average gain in length of the combination of both procedures was 16.3 mm (range 12-23 mm) with a tension force of 60 N applied.
Conclusion: The results show that a sufficient release of the iliotibial band can be achieved with the techniques except for severe cases of valgus deformation, where more effective methods to release the iliotibial band such as Z-plasty or complete dissection should be performed.