Original Article
An Anatomic Study of the Iliotibial Tract

https://doi.org/10.1016/j.arthro.2006.11.019Get rights and content

Purpose: To identify the structure of the iliotibial tract at knee level, as well as its insertions, layer arrangement, and relationship with other structures of the lateral region of the knee and to compare the findings with available literature. Methods: Ten detailed anatomic dissections were performed by using incisions as recommended by the literature in fresh cadaver knees identifying the iliotibial tract components. Results: The authors observed an iliotibial tract arrangement in superficial, deep, and capsular-osseous layers. Insertions have been described as follows: at linea aspera, at the upper border of the lateral epicondyle, at the patella, and at Gerdy’s tibial tuberculum and across the capsular-osseous layer. Conclusions: The iliotibial tract (ITT) has important interconnections to the femur, the patella, and the lateral tibia; the iliopatellar band joins the ITT to the patella through the superficial oblique retinaculum and the lateral femoropatellar ligament, and the ITT capsular-osseous layer presents differentiated fibers in an arched arrangement that borders the femoral condyle and inserts laterally to the Gerdy’s tubercle. Clinical Relevance: The iliotibial tract can be considered as an anterolateral knee stabilizer, particularly its capsular-osseous layer, which, together with the anterior cruciate ligament, constitutes a functional unit forming a spatial “horseshoe” form. The detailed description of the structures forming iliotibial tract plays an important role in the study of knee instabilities. Its important tibial, femoral, and patellar conections are described so that better understanding of tibial femoral instability on the lateral side as well as patellofemoral instability can be achieved and mechanisms of repair can be conceived.

Section snippets

Methods

Ten fresh cadaver knees, with ages ranging from 33 to 66 years and with no previous pathology or injury identifiable, have been dissected. From those, 9 were men and 1 was a woman (9 right knees and 1 left knee). All dissections were made at the Death Verification Service in São Paulo City. Data for corpses have been recorded, such as initial letters of the names, gender, height, weight, and age, with photographic documentation being performed for each dissection. The results of that research

Results

The results of our anatomic study have been described by means of layers, from the superficial layer to the deep layer, and across its various insertions.

Discussion

The lateral compartment of the knee extends from the lateral portion of the patellar tendon to the posterior cruciate ligament.12 In this compartment, we noticed ligament and musculotendinous components that are essential to both static and dynamic stability of the joint. The ITT plays an important role in this function.

After a detailed study of the ITT’s macroscopic structure, we could see its importance as a static and dynamic stabilizer for the knee. Because of its insertion at the linea

Conclusions

The ITT has important interconnctions to the femur, the patella, and the lateral tibia. The iliopatellar band joins the ITT to the patella through the superficial oblique retinaculum and the lateral femoropatellar ligament. The ITT capsular-osseous layer presents differentiated fibers in an arched arrangement that borders the femoral condyle and inserts laterally to the Gerdy’s tubercle.11, 13

Acknowledgment

The authors thank Paulo Roberto Godoy for the illustrations of the anatomic dissections.

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The authors report no conflict of interest.

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