Endoscopic Resection of Distal Femoral Exostosis That Causes Distal Iliotibial Band Syndrome

Abstract

Distal iliotibial band (ITB) syndrome is the most common cause of lateral knee pain in runners. If the ITB is too tight, the repetitive knee flexion associated with sports may lead to compression of the vascularized fat pad in the sub-ITB space or development of sub-ITB adventitious bursitis as the band crosses over the lateral femoral epicondyle and the ITB itself is normal. Distal ITB syndrome usually responds to conservative treatment. The presence of any underlying causes, for example, exostosis at the sub-ITB space, should be explored in recalcitrant cases of distal ITB syndrome. Although open surgical excision is the treatment of choice for extra-articular exostosis, the surgical risk and complication rates have been reported as high as 13%. Endoscopic resection of extra-articular exostosis has been proposed to reduce the complication rates. The purpose of this technical note is to describe the details of arthroscopic management of endoscopic resection of distal femoral exostosis that causes distal ITB syndrome.