Lateral Collateral Ligament and Proximal Tibiofibular Joint Reconstruction for Tibiofibular Instability

Instability of the proximal tibiofibular joint (PTFJ) can be post-traumatic or due to accumulative injuries and may also be underdiagnosed pathology that can present with symptoms of lateral and/or medial knee pain. It can be associated with subtle instability and subluxation or frank dislocation of both the PTFJ and the native knee joint. Previously described techniques have been either nonanatomic, require secondary hardware removal, disrupt native anatomy, or fail to account for the inherent stabilizing effect of the lateral collateral ligament, which is likely additionally injured or lax in these patients. The purpose of this Technical Note is to present an open anatomic reconstruction of the PTFJ and lateral collateral ligament using a single semitendinosus allograft, thus restoring all anatomic constraints to the PTFJ and lateral knee.