Iliotibial band release significantly improves pain, function, and quality of life in patients with isolated patellofemoral osteoarthritis: A 2-year retrospective study.

Abstract

Patellofemoral osteoarthritis (PFOA) is a common source of anterior knee pain (AKP), often associated with lateral patellar overload and iliotibial band (ITB) tightness. While multiple-surgical options exist, there is no consensus on optimal treatment, and evidence supporting ITB release is limited. This study aimed to evaluate whether isolated ITB release leads to significant clinical improvements in patients with PFOA who are refractory to conservative management. We conducted a retrospective cohort study of patients who underwent ITB release for symptomatic PFOA between 2018 and 2021. The inclusion criteria were failure of conservative therapy for more than 3 months and completion of the Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire both pre operatively and at 2 years of follow-up. Radiographic diagnosis of Iwano stage -PFOA was confirmed using magnetic resonance imaging (MRI) or plain radiographs. Paired t-tests were used to assess KOOS score improvements. Correlations between outcomes and patient characteristics (age, gender, Iwano grade) were also analyzed. A total of 44 patients (25 males, 19 females; mean age 50.1 years) were included in the final analysis. At the 2-year follow-up, statistically significant differences were observed across all five KOOS subscales. The mean improvements (difference in scores from pre operative and 2-years follow-up) of subscale scores were as follows: pain by 24.5 (p ​< ​0.05), symptoms by 21.7 (p ​< ​0.05), activities of daily living (ADL) by 19 (p ​< ​0.05), sport by 24.5 (p ​< ​0.05), and quality of life (QoL) by 33.5 (p ​< ​0.05). Correlation analyses revealed no statistically significant associations between KOOS improvements and patient baseline characteristics. Importantly, no post operative complications were reported during the follow-up period. ITB release significantly improves all KOOS subscale scores in patients with PFOA who fail conservative treatment. It represents a safe and effective joint-preserving option for this challenging condition. IV.