The Influence of Iliotibial Tract on Patellar Tracking

Thirty patients with 49 snapping hips and patellar malalignment underwent surgical release of the iliotibial tract contracture over the trochanteric area. Minimal follow-up was 2 years (average 4.6 years, range: 2-9 years). Eight patients underwent computed tomography (CT) preoperatively and 1 month postoperatively to investigate the patellar location in the patellofemoral articulation with knee bending at 0 degrees, 20 degrees, 45 degrees, 60 degrees, and 90 degrees. Significant improvements in the congruence angle and lateral patellofemoral angle were noted on Merchant radiograph for all knees (P<.01). On CT, at 20 degrees and 45 degrees knee bending, all congruence, lateral patellofemoral, and patellar tilt angles significantly improved postoperatively in 8 knees (P<.01). Iliotibial tract affects patellar tracking and dominates lateral patellar supporting structures.