Clinical Characteristics and Outcomes After Anatomic Reconstruction of the Proximal Tibiofibular Joint
Related Experiment Video
Updated: Dec 28, 2025
Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
Published on: January 24, 2018
Travis J Dekker1, Nicholas N DePhillipo2, Mitchell I Kennedy3
1Steadman Clinic, Vail, Colorado, U.S.A.
Purpose:
To assess the most common presenting symptoms, clinical outcomes, and satisfaction after anatomic reconstruction of the proximal tibiofibular joint (PTFJ) with a free semitendinosus autograft.
Methods:
Consecutive patients with minimum 2-year follow-up after isolated anatomic PTFJ reconstruction were retrospectively reviewed. Patients were evaluated with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score and Lysholm Knee Survey score along with a simple numeric patient satisfaction score (0-10, with 10 rated as perfect). Statistical analysis was performed with paired t tests, with P < .05 considered significant.
Results:
The study included 16 PTFJ reconstruction surgical procedures in 15 patients with isolated proximal tibiofibular instability verified by an examination under anesthesia (4 reconstructions in male patients vs 12 in female patients); the average age was 37.9 ± 14.6 years, with an average follow-up period of 43.2 months (range, 22-72 months). Of the 13 patients with complete follow-up, 11 (84.6%) were able to return to full desired activities and previous level of sport. Fourteen patients presented with concomitant common peroneal nerve pathology. Two patients had a subsequent complication. No patients needed an additional procedure. Significant (P < .05) improvement occurred across all WOMAC domains and in the WOMAC total score, from 31.4 (±14.9) preoperatively to 15.2 (±15.5) postoperatively. Lysholm Knee Survey scores significantly (P < .05) improved from 51.2 (±17.2) to 75.0 (±18.0). Patients' overall satisfaction was rated 7.6 (± 2.7) of 10.
Conclusions:
At an average follow-up of 43.2 months, anatomic PTFJ reconstruction for isolated PTFJ instability provided improvement in clinical outcomes, a return to activities, and a low risk of complications or need for additional procedures.
Clinical Relevance:
PTFJ reconstruction with hamstring tendon graft is a promising surgical treatment that improves patient satisfaction when conservative treatment of PTFJ instability fails.
Level Of Evidence:
Level IV, case series.
Related Concept Videos
01:10Bones of the Lower Limb: Tibia and Fibula
01:27Fractures: Bone Repair
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...