Proximal Tibiofibular Joint Instability: Outcomes After Combined Tibiofibular Joint and Lateral Collateral Ligament...

Area of Science:

• Orthopedic surgery
• Sports medicine
• Knee reconstruction

Background:

• Proximal tibiofibular joint (PTFJ) instability is rare, with limited evidence for standardized treatment.
• Existing literature primarily addresses isolated PTFJ reconstruction, lacking data on combined procedures with other knee injuries.

Purpose of the Study:

• To evaluate subjective and clinical outcomes of combined lateral collateral ligament (LCL) and PTFJ reconstruction using a semitendinosus allograft.
• To assess the efficacy of this combined approach in patients with anterior PTFJ instability and associated knee injuries requiring additional surgical procedures.

Main Methods:

• Retrospective review of 25 patients who underwent combined LCL and PTFJ reconstruction with a semitendinosus allograft (2016-2021).
• Minimum 2-year follow-up, assessing outcomes via patient-reported outcome measures (PROs), including Lysholm, IKDC, and WOMOAT scores.
• Exclusion criteria included lower extremity fracture, prior knee surgery, connective tissue disorder, and follow-up less than 2 years.

Main Results:

• Significant improvements observed in Lysholm (49 to 95), IKDC (34 to 83), and WOMOAT (36 to 2) scores (P < .001 for all).
• 80% of patients underwent concomitant procedures, including ACL reconstruction (48%) and meniscal procedures (52%).
• No revision surgeries were required for the combined reconstruction; high sporting activity levels were maintained (Tegner: 6.0).

Conclusions:

• Combined LCL and PTFJ reconstruction with a semitendinosus allograft demonstrates favorable outcomes.
• This surgical strategy is effective even when performed concurrently with procedures for associated knee injuries.