A case of iliotibial band impingement following rotating platform total knee replacement

What is it about?

We report a case of iliotibial band impingement following rotating platform total knee replacement, presenting with lateral knee pain. Prompt diagnosis with arthroscopic release prevented a costly and traumatic revision procedure.

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Why is it important?

Rotating platform total knee replacement implants have been marketed to allow more precise approximation of normal knee kinematics and enhance patella tracking. At liberty of rotation, the distinct mobile polyethylene insert design does have its pitfalls in spite of purported merits. Iliotibial band impingement following total knee replacement is not a novel occurrence. However, to our knowledge, our case is the first in reported literature to occur in the rotating platform total knee replacement. We were able to attribute the iliotibial band impingement to an overhanging rotating polyethylene insert, and identify both dynamic and static factors that acted as a basis for the impingement, namely normal knee kinematics maintained by the screw home mechanism, rotational malalignment of the tibial tray, oversizing of the polyethylene insert and valgus tibiofemoral alignment.