Iliotibial Band Impingement by Overhanging Tibial Tray: A Pain Generator after Total Knee Replacement Treatable without Revision

Abstract

Soft-tissue impingement can cause disabling pain after total knee arthroplasty. We report a case of painful crepitus over Gerdy's tubercle after total knee replacement. Iliotibial band impingement by overhanging tibial tray was diagnosed. The symptom persisted despite physiotherapy and local corticosteroid injection. A combined arthroscopic and open approach was used to excise intraarticular scarring and release the impinged iliotibial band. The painful crepitus was resolved instantaneously without recurrence at 3 year follow-up. Morbidity associated with component revision has been avoided.