2023 ISAKOS Biennial Congress ePoster
Increased Incidence Of Accessory Illiotibial Band-Meniscal Ligament (AIML) In Patients With Runner's Knee – A Novel Anatomical Risk Factor
Farah Selman, MD, Zurich SWITZERLAND
Sandro Hodel, MD, Zurich SWITZERLAND
Alejandro Culebras Almeida, MD, Zurich SWITZERLAND
Sandro Fucentese, Prof MD, Zuerich, CH SWITZERLAND
Lazaros Vlachopoulos, MD, PhD, Zurich SWITZERLAND
Stefan Michael Zimmermann, MD, Zurich, Zurich SWITZERLAND
University Hospital Balgrist , Zurich, SWITZERLAND
FDA Status Cleared
Summary
We have investigated the presence of an accessory iliotibial band-meniscal ligament (AIML) in patients with runner's knee as a potential risk factor for the development of the disease and could show a double frequency of AIML in patients with runner's knee compared to a control group.
ePosters will be available shortly before Congress
Abstract
Introduction
The etiology of painful irritation of the iliotibial band (ITB), known as "Runner's Knee" or "Iliotibial band Syndrome", is poorly understood. Presence of an accessory iliotibial band-meniscal ligament (AIML), an anatomical variant where a ligamentous connection reaches from the iliotibial band to the anterolateral aspect of the lateral meniscus, imaginably increases mechanical stress and irritation of the ITB, potentially representing an underlying anatomical risk factor for runner’s knee.
The aim of the study was to analyze presence of the AIML in patients with symptoms of a runner’s knee. We hypothesized, that patients with runner's knee would more often have an AIML compared to a control group.
Methods
A retrospective review of 1'078 knees from 2014 to 2021 was performed. Presence of an AIML was assessed on magnetic-resonance imaging (MRI) by a blinded musculoskeletal radiologist. After review of the patient's charts, the cohort was grouped into patients diagnosed with a runner’s knee and a control group. Runner’s knee was defined as lateral sided knee pain with painful palpation of the ITB and/or the presence of MRI signs of irritation or edema of the ITB. Cases with concomitant radiological findings, which could otherwise elicit lateral knee pain (i.e. lateral meniscus lesions), were excluded. Presence of an AIML was evaluated for both groups.
Results
Sixty-seven patients with a runner's knee were identified (67/1078). Mean age in the runner's knee group was 30 ± 12 years, in the control group 39 ± 16.2 years (p = 0.008). There were no significant gender differences between the runner's knee and the control group (p = 1.000). An AIML was present in 23.9% of patients with runner's knee (n=16/67) versus 13.5% in the control group (n=136/1'011, p = 0.018). Presence of an AIML was associated with the diagnosis of a runner's knee (odds ratio: 2.02 (95% CI: 1.12-3.64)).
Conclusion
An AIML was found twice as often in patients suffering from symptoms of a runner’s knee compared to a control group. Based on these findings, the AIML appears to contribute to the development of painful runner’s knee, potentially by leading to increased ITB stress. Further biomechanical analysis is necessary to confirm this hypothesis, and research is warranted to further determine the clinical relevance of these findings.