Proximal tibiofibular joint instability: Outcomes following reconstruction with biceps femoris and iliotibial band autografts with suture tape augmentation.

BACKGROUND

Instability of the proximal tibiofibular joint (PTFJ) is an underrecognized cause of lateral knee pain and mechanical symptoms. When conservative treatment fails, surgical intervention is considered. A wide variety of techniques have been described to stabilize the joint. We assessed clinical outcomes following reconstruction of the PTFJ using iliotibial band (ITB) and biceps femoris tendon (BFT) autografts with added suture tape augmentation.

METHODS

A retrospective pre-operative chart review with additional post-operative prospective follow-up data was performed for this case series. The authors obtained patient reported outcomes for individuals who underwent reconstruction of the PTFJ with ITB and BFT autografts with suture tape augmentation. Only patients with isolated PTFJ instability that had failed conservative treatment were included. Patients' range of motion (ROM) and time to release to full activity were obtained retrospectively while satisfaction with reconstruction, Single Assessment Numeric Evaluation (SANE) Scores, and Lysholm Scores were obtained in a prospective manner.

RESULTS

Five knees in four patients (one bilateral) underwent reconstruction. All four patients were female. Their mean age was 28.2 ± 8.7 years. Mean length of follow up was 17 months. All patients returned to prior activity levels including athletic participation. One patient experienced subjective instability at five and seven months postoperatively. One patient experienced a deep vein thrombosis postoperatively which was managed with three months of systemic anti-coagulation. One patient reported subjective instability post operatively. No additional procedures were performed. Mean post-operative self-reported satisfaction score 9.8 ± 0.4 out of 10. Mean SANE and Lysholm scores were 85.6 ± 6.9 and 91.4 ± 5.4 respectively.

CONCLUSION

Treatment of PTFJ instability with ITB and BFT autografts with suture tape augmentation results in excellent clinical outcomes and patient satisfaction, with a reliable return to prior activity levels and low complication rate.