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Z-Plasty of IT Band

What is Z-Plasty of the IT Band?

Occasionally, a painful hip can also snap. There are 2 types: one is internal and is caused by the Iliopsoas tendon and the other is external and is caused by the IT band snapping over the greater trochanter. I do not treat the popping that comes from the Iliopsoas tendon. Releasing this tendon frequently results in hip flexion weakness and can imbalance the hip. Usually, the snapping of the Iliopsoas will improve once the hip is fixed with hip arthroscopy. External snapping usually begins as something that is voluntary. Over time and as the hip imbalances, it becomes more frequent and involuntary. If it becomes painful and something that you want to go away, then it can be surgically fixed. I perform a Z-Plasty lengthening of the IT band to lengthen the IT band so that it can move back and forth over the side of the hip and will no longer snap.

I perform 100% of your surgery and do not train fellows or residents. I take the responsibility you have entrusted me with very seriously and put everything that I have into your operation.

Published Studies

Severe Pincer Study:

Do you have a very deep Cup or Acetabulum? This study focuses on my technique for Severe Pincer Type FAI with significant reduction of the over-coverage and Labral Reconstruction. This technique was 98% successful for this very challenging deformity.

Published Study: Severe Pincer Study

Expanding Evidence: 2022 Labral Reconstruction Review:

I was asked to write another review paper in 2022 as evidence in support of Labral Reconstruction has expanded significantly in the last 10 years.

Published Study: Expanding Evidence: 2022 Labral Reconstruction Review

Hip labral reconstruction:

Most debates on this issue in which I have participated have focused on labral reconstruction vs. repair or debridement. Therefore, I see this opportunity to discuss the advantages of complete labral reconstruction vs. segmental grafting as a sign of progress.

Published Study: Hip labral reconstruction

Over 40 study:

Are you over 40 years old? This paper directly compares Labral Reconstruction to Labral Repair in over 300 patients. Labral Repairs failed almost 3 ½ times more than the Labral Reconstructions. This paper proves that Labral Reconstruction is the best surgery in this age group.

Published Study: Over 40 study

Bilateral Study:

This is a clean comparison study of 29 patients that I performed a Labral Repair on one side and a Labral Reconstruction on their other hip. None of the Reconstructions failed and 31% of the Labral Repairs required another surgery. This proves Labral Reconstruction in my hands is simply a better operation.

Published Study: Bilateral Study

Revision Study:

This paper proved that Labral Reconstruction is the best surgery for people who have had a previous hip arthroscopy that did not work.

Published Study: Revision Study

1st Labral Reconstruction Study:

This was my first paper on Allograft Labral Reconstruction of the hip and the first to describe my “Front to Back” technique. It also validated the use of donor tissue for the graft.

Published Study: 1st Labral Reconstruction Study

Original Labral Reconstruction Technique Description:

This is my original description of my “Front to Back” allograft labral reconstruction technique.

Published Study: Original Labral Reconstruction Technique Description

Femur Fracture:

This looked at patients who had broken their femur and still had pain in the hip after it was fixed. It showed that sometimes the pain is not from the fracture or the hardware used to fix it, it can be from a torn labrum.

Published Study: Femur Fracture

Review Paper-when to perform and how:

This is a paper that I was asked to write several years ago to summarize my experience and the literature support at that time for labral reconstruction.

Published Study: Review Paper-when to perform and how

General Post-Op Instructions

Rehabilitation following surgery, in many instances, is as important as the surgery itself. It requires a commitment from the patient to make it a part of their daily routine. I believe that physical therapists and athletic trainers have an integral role in guiding and assisting patients through this process. I will work with both you and your therapist to ensure that your rehabilitation is appropriate and that you are progressing and improving, as you should.

Orthopaedic rehabilitation is always tailored to the individual patient’s goals and is affected by the type of surgery that was performed and intra-operative findings.  The total duration for therapy and progression to return to full activity is always individualized.  Please see these links for more information on therapy guidelines for specific surgeries

“Meeting Dr. White was life-changing. If I could tell anyone suffering from a labral tear one thing, it would be DON'T have surgery ANYWHERE else. I only wish I would've found him *before* I had 2 failed surgeries elsewhere. The procedure he does is above and beyond any other solution available. Massive bonus points: he's one of those (very) rare providers who has a genuine interest in and care for his patients personally- to resolve every aspect of the problem in order that we can return to a fully active life doing the things we enjoy doing with the people we love.”