Iliotibial Band Tenodesis

The goal of lateral extra-articular augmentation or reconstruction is to eliminate residual laxity and reduce the risk of ACL graft rupture. Two common techniques include iliotibial band (ITB) tenodesis and anterolateral ligament (ALL) reconstruction. These procedures play a role in augmenting rotational stability in the ACL-reconstructed knee. Patients who see the greatest benefit include hyperlax patients, revision cases, pivoting athletes, and those with IKDC Grade III pivot shifts.

There are several distinct advantages of using adjustable, tensionable implant technology, such as the Knotless FiberTak® anchor or FiberTag® TightRope® implant, when compared to traditional techniques using staples or interference screws:

  • Simple: Quick, easy, and reproducible techniques
  • Safe: Knotless FiberTak anchor sets just below the cortex, reducing the risk of femoral tunnel convergence of the ACL; the self-punching anchor technique is designed to reduce the risk of damaging the ACL graft as with traditional techniques that require drilling; no risk of graft laceration as described with interference-screw techniques1
  • Low profile: Techniques using additional hardware, such as staples, may lead to pain or discomfort, warranting removal; no prominent hardware is part of the Knotless FiberTak anchor or TightRope implant1
  • Preserves anatomy: No socket drilling involved in the Knotless FiberTak onlay technique
  • Titratable graft tensioning: Using these techniques, a surgeon can provisionally tension and incrementally retension the graft after checking for isometry and overconstraint

Reference

1. Muller B, Willinge GJA, Zijl JAC. Minimally invasive modified Lemaire tenodesis. Arthrosc Tech. 2020;10(1):e29- e36. doi:10.1016/j.eats.2020.09.006

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The goal of lateral extra-articular augmentation or reconstruction is to eliminate residual laxity and reduce the risk of ACL graft rupture. Two common techniques include iliotibial band (ITB) tenodesis and anterolateral ligament (ALL) reconstruction. These procedures play a role in augmenting rotational stability in the ACL-reconstructed knee. Patients who see the greatest benefit include hyperlax patients, revision cases, pivoting athletes, and those with IKDC Grade III pivot shifts.

There are several distinct advantages of using adjustable, tensionable implant technology, such as the Knotless FiberTak® anchor or FiberTag® TightRope® implant, when compared to traditional techniques using staples or interference screws:

  • Simple: Quick, easy, and reproducible techniques
  • Safe: Knotless FiberTak anchor sets just below the cortex, reducing the risk of femoral tunnel convergence of the ACL; the self-punching anchor technique is designed to reduce the risk of damaging the ACL graft as with traditional techniques that require drilling; no risk of graft laceration as described with interference-screw techniques1
  • Low profile: Techniques using additional hardware, such as staples, may lead to pain or discomfort, warranting removal; no prominent hardware is part of the Knotless FiberTak anchor or TightRope implant1
  • Preserves anatomy: No socket drilling involved in the Knotless FiberTak onlay technique
  • Titratable graft tensioning: Using these techniques, a surgeon can provisionally tension and incrementally retension the graft after checking for isometry and overconstraint

Reference

1. Muller B, Willinge GJA, Zijl JAC. Minimally invasive modified Lemaire tenodesis. Arthrosc Tech. 2020;10(1):e29- e36. doi:10.1016/j.eats.2020.09.006

View More

Educational Resources and Products

Iliotibial Band Tenodesis Using the FiberTag® TightRope® Implant

Michael G. Baraga, MD
Surgical Technique Videos | 05:15 | English | 06/24/2020 | VID1-000894-en-US A

LET Using the FiberStaple™ Technique With the Self-Punching 2.6 Knotless FiberTak® Anchor

Justin J. Mitchell, MD
Surgical Technique Videos | 05:58 | English | 02/13/2023 | VID1-002778-en-US A
Iliotibial Band Tenodesis With FiberTag® TightRope® Implant
Iliotibial Band Tenodesis With FiberTag® TightRope® Implant
Surgical Technique Guides | English | 11/04/2020 | LT1-000185-en-US A
IT Band Tenodesis With The Self-Punching 2.6 mm Knotless FiberTak Soft Anchor
IT Band Tenodesis With The Self-Punching 2.6 mm Knotless FiberTak Soft Anchor
Surgical Technique Guides | English | 10/13/2021 | LT1-000224-en-US A
Iliotibial Band Tenodesis Using a 4.75 mm PEEK SwiveLock® Anchor Kit
Iliotibial Band Tenodesis Using a 4.75 mm PEEK SwiveLock® Anchor Kit
Brian J. Cole, MD, MBA
Surgical Technique Videos | 07:58 | English | 11/16/2020 | VID1-000824-en-US B
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Surgical Technique Videos (6)

LET Using a Double Knotless Knee FiberTak® Anchor in a FiberStaple™
Technique
LET Using a Double Knotless Knee FiberTak® Anchor in a FiberStaple™ Technique
Walter Lowe, MD
08:14 | English | 08/07/2023 | VID1-003813-en-US A
Deep Iliotibial Band Reconstruction Using Double-Loaded Knotless Knee FiberTak® Anchors
Deep Iliotibial Band Reconstruction Using Double-Loaded Knotless Knee FiberTak® Anchors
Adam Anz, MD
11:37 | English | 07/18/2023 | VID1-003855-en-US A
LET Using the FiberStaple™ Technique With the Self-Punching 2.6 Knotless FiberTak® Anchor
LET Using the FiberStaple™ Technique With the Self-Punching 2.6 Knotless FiberTak® Anchor
Justin J. Mitchell, MD
05:58 | English | 02/13/2023 | VID1-002778-en-US A
Iliotibial Band Tenodesis Using a 4.75 mm PEEK SwiveLock® Anchor Kit
Iliotibial Band Tenodesis Using a 4.75 mm PEEK SwiveLock® Anchor Kit
Brian J. Cole, MD, MBA
07:58 | English | 11/16/2020 | VID1-000824-en-US B
Iliotibial Band Tenodesis Using the FiberTag® TightRope® Implant
Iliotibial Band Tenodesis Using the FiberTag® TightRope® Implant
Michael G. Baraga, MD
05:15 | English | 06/24/2020 | VID1-000894-en-US A
Iliotibial Band Tenodesis
Iliotibial Band Tenodesis
Frank A. Cordasco, MD, MS
03:32 | English | 11/12/2018 | VID1-01391-EN A

Surgical Technique Animations (1)


Surgical Technique Guides (4)


Orthopedia.com Video Links (1)

OTIF: Technique Update—Lateral Extra-Articular Tenodesis in the Knee
OTIF: Technique Update—Lateral Extra-Articular Tenodesis in the Knee
English | 02/21/2022 | LINK_VID1-003220-en-US A

Presentation Videos (2)

Extra-articular Tenodesis and ALL Reconstruction
Extra-articular Tenodesis and ALL Reconstruction
Asheesh Bedi, MD
11:50 | English | 06/04/2020 | VID1-000946-en-US A
Management of the Anterolateral Complex of the Knee
Management of the Anterolateral Complex of the Knee
Seth L. Sherman, MD
12:05 | English | 01/29/2020 | VID1-000592-en-US A

Scientific Updates (1)

Extra-articular Augmentation Scientific Update
Extra-articular Augmentation Scientific Update
English | 10/20/2022 | LA1-00037-EN E
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