Lagoon Tibial Band Impact Syndrome

The iliotibial band somehow connects the hip to the knee, allowing support and movement. It is the largest fascia in the human body and its proper function is extremely important. In the wider area of the knee, where the ligament of the hamstring ends, there is a serous sac. The presence of the serous tubercle allows the ligament to be connected to the joint at the point of the femoral condyle. Therefore, when hyperextension occurs, i.e. repeated flexion and extension of the knee, the ligament is stressed. This results in micro-tears of the ligament, irritation or inflammation which can also be found in the serous bursa.

Lagoon ligament syndrome is a condition of hyperplasia caused by inflammation affecting the outer surface of the knee. The inflammation usually develops at the friction point between the ligament of the hamstring and the outer femoral condyle when the friction is prolonged. The result of the inflammation is severe pain in the knee area, which is aggravated by movement of the joint or when the heel is resting on the ground, as well as by walking up and down stairs. Sometimes the sufferer feels a grinding sensation in the joint.

• Pain located in the region of the iliotibial band that repeatedly slides over the outer femoral condyle.

• Pain occurs when the heel touches the floor and may extend to the outer surface of the thigh and gastrocnemius.

• The classic clinical picture of iliotibial band friction syndrome is:

  - The patient is fine when starting exercise.

  - The pain starts after a certain distance or time from the start of exercise.

  - If they continue exercise, the pain gets worse.

  - Pain is relieved by rest.

  - Patients tend not to experience pain with exercises that involve less knee flexion, such as the elliptical machine.

• The following factors make the pain worse:

  - Running downhill.

  - Running long distances.

  - Running down stairs.

Conservative Treatment

The treatment of Lagoon Tendonitis Syndrome is usually conservative and aims to gradually reduce and eliminate pain through the treatment of inflammation, and the gradual return of the patient to his/her activities. It includes:

• Rest.

• Cryotherapy.

• Administration of anti-inflammatory drugs.

• Corticosteroid injection.

• Physiotherapy.

• Platelet-rich plasma (PRP) therapy.

Surgical Treatment

If the patient does not respond to the above treatments and the symptoms persist, then the invasive route is chosen. Surgical treatment is considered necessary in cases where the lagoonal band syndrome is at an advanced stage, affecting the patient's daily life. In such cases, the operation involves the release of 2 cm of the ligament at the point where it touches the lateral femoral epicondyle.