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      Ligament reconstruction using a semitendinosus tendon graft for proximal tibiofibular joint disorder: Case report

      case-report

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          Abstract

          We report our case of ligament reconstruction for treatment of proximal tibiofibular joint disorder using a semitendinosus tendon graft. A 21-year-old male college soccer player with no remarkable history of injury had been suffering from pain at the lateral aspect of the left knee when playing soccer. At another hospital, the patient was diagnosed with a lateral meniscus injury and cartilage injury of the external condyle of the tibia and underwent partial resection of the meniscus and bone drilling. However, his symptoms continued, and he was referred to our institution. Instability of the left proximal tibiofibular joint and pain were noted during weight-bearing dorsiflexion of the ankle. We diagnosed the case as a proximal tibiofibular joint disorder and surgically treated it by dissecting the proximal portion of the semitendinosus tendon, creating one transfibular and two transtibial tunnels, and then reconstructing the proximal tibiofibular ligament using the harvested semitendinosus tendon graft. The patient was allowed to run at postoperative 2 months, with no pain occurring while squatting at postoperative 3 months, subsequently resuming soccer at postoperative 8 months. The proximal tibiofibular joint disorder is a relatively rare pathology, and diagnosis and conservative treatment are often difficult. Although various surgical treatments are known, the clinical outcome of our case has been successful after reconstructing the anterior and posterior proximal tibiofibular ligaments using a semitendinosus tendon graft.

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          Most cited references6

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          Proximal Tibiofibular Joint Instability and Treatment Approaches: A Systematic Review of the Literature.

          To evaluate the treatment options, outcomes, and complications associated with proximal tibiofibular joint (PTFJ) instability, which will aim to improve surgical treatment of PTFJ instability and aid surgeons in their decision making and treatment selection.
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            Instability of the proximal tibiofibular joint.

            Injury to the proximal tibiofibular joint is typically seen in athletes whose sports require violent twisting motions of the flexed knee. Instability of this joint may be in the anterolateral, posteromedial, or superior directions. With acute injury, patients usually complain of pain and a prominence in the lateral aspect of the knee. A closed reduction should be attempted in patients with acute dislocation. If this is unsuccessful, open reduction and stabilization of the joint with repair of the injured capsule and ligaments can be done. Patients with chronic dislocation or subluxation report lateral knee pain and instability with popping and catching, which may be confused with lateral meniscal injury. Symptoms of subluxation may be treated nonsurgically with physical therapies such as activity modification, supportive straps, and knee strengthening. For patients with chronic pain or instability, surgical options include arthrodesis, fibular head resection, and proximal tibiofibular joint capsule reconstruction.
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              The forgotten joint: quantifying the anatomy of the proximal tibiofibular joint

              Limited objective data exist detailing the quantitative anatomy of the individual bundles of the proximal tibiofibular joint and their relation to surgically pertinent osseous landmarks. The purpose of this study was to qualitatively and quantitatively describe the ligamentous anatomy of the proximal tibiofibular joint and its relation to relevant bony landmarks.
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                Author and article information

                Journal
                SICOT J
                SICOT J
                sicotj
                SICOT-J
                EDP Sciences
                2426-8887
                2022
                01 April 2022
                : 8
                : ( publisher-idID: sicotj/2022/01 )
                : 8
                Affiliations
                [1 ] Department of Orthopaedic Surgery, Kyoto Kujo Hospital 10 Karahashi Rajomon, Minami-ku Kyoto Kyoto 601-8453 Japan
                [2 ] Department of Orthopaedic Surgery, Nippon Medical School 1-1-5 Sendagi Bunkyo-ku Tokyo 113-8602 Japan
                Author notes
                [* ]Corresponding author: ma6-0336@ 123456nms.ac.jp
                Article
                sicotj210120 10.1051/sicotj/2022008
                10.1051/sicotj/2022008
                8973301
                35363134
                c7d089a7-fd25-42d9-8548-1f8f10177b8d
                © The Authors, published by EDP Sciences, 2022

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 16 December 2021
                : 19 February 2022
                Page count
                Figures: 4, Tables: 0, Equations: 0, References: 5, Pages: 4
                Categories
                Case Report
                Knee

                tibiofibular joint,semitendinosus tendon,ligament,reconstruction

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