The Archives of Bone and Joint Surgery

The Archives of Bone and Joint Surgery

The Effect of Iliotibial Band Tightness and Its Release on Postoperative Pain after Total Knee Arthroplasty in Patients with Varus Gonarthrosis: A Randomized Clinical Trial

Document Type : RESEARCH PAPER

Authors
Hosseinali Hadi 1
Mohammad Zarei Dezkooh 2
Mohammad H. Ebrahimzadeh 3
1 Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran
2 Arak University of Medical Sciences, Arak, Iran
3 Orthopedics Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
10.22038/abjs.2026.89903.4090
Abstract
Objectives: This study aimed to evaluate the effect of iliotibial band (ITB) release on postoperative pain and functional outcomes following total knee arthroplasty (TKA) in patients with varus gonarthrosis.
Methods: This clinical trial included patients with varus gonarthrosis undergoing total knee arthroplasty (TKA). Participants were stratified into three groups: Group A, patients with a tight ITB who did not undergo ITB release; Group B, patients with a tight ITB who underwent ITB release; and Group C, patients with a loose ITB who did not undergo release. Outcome measures included the Knee Society Score (KSS) knee and function subscales and the Oxford Knee Score (OKS), which assesses pain and functional status. Evaluations were performed preoperatively and at three months and one year postoperatively.
Results: No significant differences were observed among the three groups regarding age or gender (P > 0.05). At baseline, Group B demonstrated a significantly lower mean KSS compared with the other groups (P = 0.017). Although Group B showed improvement in mean KSS at the final follow-up, no statistically significant differences in postoperative KSS (P = 0.468) or OKS (P = 0.194) were found among the groups at any follow-up time point. Furthermore, the incidence of subluxation and the severity of varus deformity were comparable across all groups.
Conclusion: In patients with a tight ITB undergoing TKA, ITB release is associated with improvement in functional scores compared with preoperative values; however, it does not lead to significant differences in clinical or radiographic outcomes when compared with patients who do not undergo ITB release. These findings suggest that ITB release may have a limited effect on overall postoperative outcomes, underscoring the need for further studies to more comprehensively evaluate the role and indications of surgical release techniques.
        Level of evidence: I
Keywords
Iliotibial band
Pain
Total knee arthroplasty
Varus gonarthrosis
Subjects
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The Archives of Bone and Joint Surgery
Volume 14, Issue 2
February 2026
Pages 113-120

  • Receive Date 11 August 2025
  • Revise Date 23 December 2025
  • Accept Date 11 January 2026