When Does IT Band Syndrome Require Surgery?

IT band syndrome, short for iliotibial band syndrome, is a common condition characterized by pain on the outer side of the knee. While most IT band syndrome cases can be effectively managed with conservative treatments such as rest, physical therapy, and stretching exercises, there are instances where surgery may be necessary to alleviate symptoms and restore function.

What Is IT Band Syndrome?

The iliotibial band is a thick band of connective tissue that runs along the outside of the thigh, from the hip to the knee. IT band syndrome occurs when this band becomes irritated or inflamed, typically as a result of overuse or repetitive motion. Runners, cyclists and athletes who engage in activities that involve repetitive bending and straightening of the knee are particularly susceptible to IT band syndrome.

When Conservative Treatments Fail

In most cases, IT band syndrome can be effectively managed with conservative treatments such as rest, ice, anti-inflammatory medications, physical therapy and stretching exercises. Some cases of IT band syndrome are aggravated by hip bursitis and can be alleviated with bursitis treatments. However, if symptoms persist despite these conservative measures, surgery may be considered.

Indications for Surgery

Surgery for IT band syndrome is typically reserved for cases where conservative treatments have failed to provide relief, and the patient continues to experience significant pain and functional limitations. Some indications for surgery may include:

• Persistent Pain: If the pain associated with IT band syndrome persists despite several months of conservative treatment, surgery may be necessary to address underlying structural issues contributing to the pain.
• Structural Abnormalities: In some cases, IT band syndrome may be caused by structural abnormalities such as a tight IT band, bony abnormalities or abnormalities in the alignment of the lower extremity. Surgery may be needed to correct these underlying issues and alleviate symptoms.
• Recurrent Symptoms: Patients who experience recurrent episodes of IT band syndrome despite conservative treatments may benefit from surgical intervention to address the underlying cause of the problem and prevent future recurrences.

If IT band syndrome is significantly impacting a patient’s ability to perform daily activities or participate in sports or recreational activities, surgery may be recommended to improve function and quality of life.

Surgical Options for IT Band Syndrome

There are several surgical options available for the treatment of IT band syndrome, including:

• IT Band Release: During an IT band release surgery, the tight or inflamed portion of the IT band is surgically released to relieve tension and reduce friction between the band and the underlying structures.
• Lateral Release: In cases where the IT band is pulling excessively on the kneecap (patella), a lateral release surgery may be performed to release the tight structures on the outer side of the knee and realign the patella.
• Arthroscopic Surgery: Arthroscopic surgery, which involves using a small camera and specialized instruments inserted through small incisions, may be performed to visualize and address any intra-articular pathology contributing to IT band syndrome.

While most cases of IT band syndrome can be effectively managed with conservative treatments, surgery may be necessary in certain cases where symptoms persist or recur despite conservative measures. By addressing underlying structural issues and restoring normal biomechanics, surgery can help alleviate pain and improve function in patients with chronic or severe IT band syndrome. If you are experiencing persistent knee pain or functional limitations due to IT band syndrome, contact our orthopedic team at Robotic Joint Center to explore your treatment options and determine if surgery is right for you. Call our orthopedic clinic in NYC to schedule your exam and consultation.