Iliotibial band impingement by overhanging tibial tray: A pain generator after total knee replacement treatable without revision

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. 全膝關節置換術後軟組織夾擠可導致疼痛。 我們報告了一宗全膝關節置換後捷耳弟氏(Gerdy's)結節疼痛的病例，其後診斷為脛骨部件突出所致的髂脛帶夾擠 。症狀於物理治療和局部皮質類固醇注射後持續。我們使用了聯合關節鏡和開放方法來消除關節內瘢痕並釋放鬆了髂脛帶。疼痛於術後即刻解獲舒緩，並在3年隨訪覆查時無復發。這技術避免了關節翻換及其相關問題。