Effect of Increased Iliotibial Band Load on Tibiofemoral Kinematics and Force Distributions: A Direct Measurement in Cadaveric Knees

Abstract

Controlled laboratory study using cadaveric knee specimens and a repeated-measures design. To investigate the effect of increased iliotibial band load (assumed to represent increased tensor fascia latae and gluteus maximus strength) on tibiofemoral kinematics and force distribution on the tibiofemoral articulation. Owing to the difficulty in measuring in vivo joint loading, there is limited evidence on the direct relationship between increased iliotibial band load and force distribution in the tibiofemoral articulation. Eight fresh-frozen cadaveric knee specimens were used in this study. A robotic testing system assessed tibiofemoral kinematics under 3 simulated loading conditions: (1) 300-N quadriceps load, 100-N hamstrings load, 0-N iliotibial band load; (2) 300-N quadriceps load, 100-N hamstrings load, 50-N iliotibial band load; and (3) 300-N quadriceps load, 100-N hamstrings load, 100-N iliotibial band load. The load distribution in the medial and lateral tibiofemoral articulation was also measured under these loading conditions by using piezoelectric pressure sensors. Data were collected and analyzed at full extension and at 5°, 10°, 15°, 20°, 25°, and 30° of knee flexion. The loads transmitted through the medial tibiofemoral articulation significantly decreased when the load on the iliotibial band was increased, with a concomitant significant increase in lateral tibiofemoral articulation load. Greater iliotibial band load also increased anterior tibial translation and valgus tibial rotation, and decreased the amount of internal tibial rotation and medial tibial translation. The present study demonstrated that an increase in iliotibial band load, when tested in a non-weight-bearing condition in a cadaveric model, can significantly decrease the loads transmitted through the medial tibiofemoral articulation.