Iliotibial band surgery?

[CindyLou]

Does anyone out there know anything, or have experience with iliotibial band release surgery? As my hip doctor gave me another round of injections in my trochanteric bursas this week, he says what is likely triggering the inflammation is my super tight IT Bands. And what may be the culprit of my super tight IT Bands is bowed-legs, and a hx of leg length discrepancy. It seems no matter how much stretching I do, I cannot get away from how tight they are. They then, in turn, bring on my trochanteric bursitis, after the injections wear off. It's just a vicious cycle. The doctor is not knife happy, by any means, and sees it as a last resort. I'm just very curious if anyone has had this surgery and the results. Thanks.

[Harrison]

CindyLou,

I’ve not talked to anyone that had this surgery. But I wonder:

1. Could there be other issues that may be contributing to the IT band condition? Have you ruled out other underlying pathologies?
2. Have you had physical and/or massage therapists assess & palpate the IT band and adjacent tissues? Are there any other detectable anomalies, like bumps, serrated areas?
3. IT bands are hard to stretch. Assuming you found effective methods, does stretching help?

You probably saw this article; there are other referred links within this one too:

Arthroscopic Bursectomy With Concomitant Iliotibial Band Release for the Treatment of Recalcitrant Trochanteric Bursitis

Derek Farr D.O. Harlan Selesnick M.D.Chet Janecki M.D.and Daniel Cordas M.D.
Doctors’ Hospital, Orthopedic Institute of South Florida, Coral Gables, Florida, U.S.A.

Available online 25 January 2007. Abstract

Trochanteric bursitis with lateral hip pain is a commonly encountered orthopaedic condition. Although most patients respond to corticosteroid injections, rest, physical therapy (PT), stretching, and anti-inflammatory medications, those with recalcitrant symptoms may require operative intervention. Studies have explored the use of the arthroscope in the treatment of these patients. However, these reports have not addressed the underlying pathology in this chronic condition.

We believe that the iliotibial band must be addressed and is the main cause of pain, inflammation, and trochanteric impingement leading to the development of bursitis. We report a new technique for arthroscopic trochanteric bursectomy with iliotibial band release. Our technique involves 2 incisions—one 4 cm proximal to the greater trochanter along the anterior border of the iliotibial band, and the other 4 cm distal and along the posterior border. The 30° arthroscope is introduced through the inferior portal, and a cannula is introduced through the superior portal. A 5.5-mm arthroscopic shaver is inserted through the superior cannula to clear off the surface of the iliotibial band, so that it may be adequately visualized. A hooked electrocautery probe is then used to longitudinally incise the iliotibial band until it no longer rubs, causing impingement over the greater trochanter.

[CindyLou]

Harrison, thanks for the information. (I have been out of town, so hence, delay in my response) I am not sure what other, if any, pathologies could exist. I do see my physical therapist on Monday, and will ask her. I do not have much success with stretching the IT Band at all. And it definitely aggravates my trochanteric bursitis. On a happier note, I did just get back from Vail, and enjoyed a week of skiing. My back did great. Stiff at end of the day, but nothing I couldn't live with. Yea!!!!!!

[Nairek]

CindyLou,
Back in 2005 I had horrendous knee pain, usually at night when moving my leg. I went to see an orthopedic & his thought was that I may have Iliotibial Band Syndrome. After an MRI, it showed that I had a torn lateral meniscus & he decided that it wasn't Iliotibial Band Syndrome.

I've still been trying to figure out why my thigh (same leg as the bad knee) has been swollen since my MVA in 12/02. Did you have similar symptoms?

[CindyLou]

Nairek, I don't believe I have any visible swelling in my thigh. It is my side of hip, the trochanteric bursa, that is very tender to the touch....and unable to sleep on affected side. My side of the knee is tender too, where the IT Band is, but the hip pain is actually more pronounced. Don't know if that explains it for you very well.

[cervie queen]

After almost two years of hip problems, which was during the two years post lumbar surgery, I finally went to a hip specialist. My symptoms were that both hips, especially my left, hurt so badly that I was not able to walk much further than to the mailbox. He quickly diagnosed It problems and sent me to physical therapy. They did a bunch of stretching which helped a little, but not much. I went back to the doctor, but after waiting in his waiting room for almost two hours, I got disgusted and walked out and haven't been back since. I then decided to get serious about exercise and do my own thing. I started going to water aerobics 4-5 times a week and gradually worked my way up on the recumbent bike. With the bike I started out and could only do two minutes. Now I routinely do 20 minutes on level 4, using either the random or hill function.

Bottom line, my hips are 90% better, in that I can walk much farther without much hip pain. I also massage the IT bands myself each day while doing stretches.

Hope this helps and encourages.

[Terry]

There seems to be a recurrent theme going on here. Since the body works as a system, I am wondering how much of the hip and knee symptoms are related to our spinal disease. Or, could it be the other way around? It just seems to be an issue that is getting much more attention lately with us spiney's. I had ITB Syndrome many years ago and needed cortisone shots to calm it down. It almost prevented me from riding my bicycle across the United States. About 1,000 miles in to the trip I rode the pain out and have not had an issue with the ITB since. However, I have had plantar fasciitis which has been very painful. I wore orthotics for the longest time but have not had to since getting my MBT Shoes and having my spine surgery.

So this is an interesting post and I am hoping that the more knowledgeable people like Harrison and Justin pipe in on this.

Cindy Lou: I am sorry you are struggling and I hope you find some relief. It sounds like the back is doing well though . Congratulations on the skiing.

Terry Newton

[JudyW]

I also have the IT band and bursa pain. My doctor has done two cortisone injections in the bursa to ease the pain. It has helped both times but I do wonder about the future. I wonder if it is or is not related to my ADR or spine problems. It would be GREAT if it wasn't then I could go through Blue Cross and get the medical care I need rather than waiting a hundred years for workers comp to stop delaying everything. UGH

[CindyLou]

I go back to neurologist (pain management doc) this morning to go over results of MRI of hip I had last week. Am very eager to see what, if anything, he comes up with. Will report back. I also got the results back from my biopsy yesterday, and it looks like I do have skin cancer on my face. Fortunately, it is the basal cell carcinoma, which typically does not enter the blood stream like melanoma. But it still has to come off. And since it is in a prominent place on my cheek, I'm nervous about how much tissue will have to be removed. The dermatologist said I will likely need a plastic surgeon after the surgery, to close the site with the best cosmetic result. Not spine related at all, but would appreciate your prayers, good thoughts sent my way. My surgery is two weeks from yesterday, May 5th.

[Terry]

Wow CindyLou,

When it rains, it pours. I'm sorry to hear that you are going through other issues after having such a major spinal surgery. I hope that the surgeon makes you pretty as a picture after removing the cancer. I also hope that you get some answers to the issues surrounding your ITB. That is painful stuff.

I hope Spring has arrived for you in Minnesota. It was a long Winter here in Northern Michigan. We had over 140" of snow. I am out on a bicycle now and this April has been awesome.

Your fellow spiney friend

Terry Newton