Autogenous iliotibial band enhancement combined with tendon lengthening plasty to treat patella baja:A case report

BACKGROUND Patella baja is a severe complication after knee injury or surgery,resulting in pain and impaired movement.This disorder is also a substantial challenge for orthopaedic surgeons.Currently,no consensus exists regarding the gold standard management of patella baja.If not appropriately treated,significant dysfunction of the knee joint will occur.CASE SUMMARY A 46-year-old man with a left patellar fracture was treated with tension band fixation at a local hospital.He had undergone a second operation at the same hospital because of limited knee flexion 6 mo after surgery.Unfortunately,the patellar tendon was ruptured.The patellar tendon was subsequently repaired using an ipsilateral semitendinosus tendon.Two years later,the patient presented to our department with knee pain and loss of range of motion.Autogenous iliotibial band(ITB)enhancement combined with sagittal tendon lengthening plasty was used to improve the symptoms of the knee joint.The patient was followed up for 2 years.The knee joint function of the patient returned to the normal level.CONCLUSION We successfully treated patella baja using autogenous ITB enhancement combined with sagittal tendon lengthening plasty.

芒针恢刺治疗髂胫束摩擦综合征-随机临床试验

Objective:to observe the clinical effect of acupuncture by mángzhen huid(relaxing needling with sharp long needle) on iliotibial band friction syndrome(ITBS).Design:this was a two-arm randomized controlled trial with blinding of participants,outcome assessment and statistician.Setting:acupuncture-Moxibustion,Tuina and Orthopedics Department and the Orthopedics Department of Shanghai the Sixth People’s Hospital,June 2018 to January 2021.Participants:a total of 64 patients with iliotibial band friction syndrome(ITBS).Interventions:with a 1:1 ratio the patients were randomly assigned to either the conventional acupuncture group(CA,n=32) or the Relaxing Needling with Sharp Long Needle group(RNSLN,n=32).The CA group was treated by applying acupuncture at Jūliáo(居髎GB 29),Fēngshì(风市GB 31),Liángqiū(梁丘ST34),Yánglingquán(阳陵泉GB 34),and Ashi points(阿是穴)of the affected side,and the RNSLN group was treated by applying relaxing needling with sharp long needle at GB 29,ST 34,and Ashi points of the affected side.Both groups were treated once every other day,10 times as one course of treatment.Outcome measures:the treatment effect was evaluated after one course of treatment by comparing their KSS scores and VAS scores,as well as overall response rate.Results:Sixty-four patients were included in the final data analysis.There was no difference in KSS and VAS scores between the two groups before treatment(P>0.05).After treatment,the KSS score of the two groups was higher than that before treatment,the VAS score of the two groups was lower than that before treatment(P<0.05).The KSS score of the RNSLN group was higher than that of the CA group,and the VAS score of the RNSLN group was lower than that of the CA group(P<0.05).The overall response rate of the RNSLN group was 93.75%,higher than 75% of the control group(P<0.05).Each group has 1case of subcutaneous bleeding as adverse event.Conclusion:Relaxing Needling with Sharp Long Needle could be more beneficial for iliotibial band friction syndrome(ITBS) compared with conventional acupuncture,and more evidence is required for its effectiveness before introducing the approach widely to clinical practice.