@kneelady I had TKR on the right knee in Oct of 2018. I have snapping and grinding of my IT band on the outside of the knee. You can actually feel it when you put your hand on the side of the knee. Uncomfortable, and somewhat painful, during the day, but excruciating/piercing pain at night when I roll over onto my left side. Wakes me up from a deep sleep. I have been going thru this night after night since Oct. Extremely frustrated. I have done 2 PT tour of duties (8 weeks) with little improvement. My OS says I have an IT band issue. No kidding!. He wants to wait until the middle of May and give me a cortisone shot. I am not a surgeon, but this would only seem to mask the underlying issue. He said that if that didn't help he may have to scope me this fall. I can definitely feel a more pronounced profile on my new knee meaning the IT and will have to stretch more than before. I feel that I either have to get a new, less pronounced insert put to replace what is there, or have the IT band lengthened. You asked if anyone has experience lengthening via putting holes in the band. I have been on multiple forums and I can not see where anyone has answered that question. At this point, I do not trust anyone. I am nervous about cutting on the IT band in fear that I may introduce another issue. I hope someone answers your question as I sure would like to get some level of confidence in that procedure. This really blows. Not happy at all.