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

Q2 Medicine

Journal of Clinical Orthopaedics and Trauma Pub Date : 2025-02-16 DOI:10.1016/j.jcot.2025.102942

Nikolas Sarac , Joseph Burger , Timothy Miller

{"title":"Proximal tibiofibular joint instability: Outcomes following reconstruction with biceps femoris and iliotibial band autografts with suture tape augmentation","authors":"Nikolas Sarac , Joseph Burger , Timothy Miller","doi":"10.1016/j.jcot.2025.102942","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"64 ","pages":"Article 102942"},"PeriodicalIF":0.0000,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical Orthopaedics and Trauma","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0976566225000384","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}

引用次数: 0

Abstract

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.

查看原文本刊更多论文

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Clinical Orthopaedics and Trauma Medicine-Orthopedics and Sports Medicine

CiteScore

4.30

自引率

0.00%

发文量

181

审稿时长

92 days

期刊介绍： Journal of Clinical Orthopaedics and Trauma (JCOT) aims to provide its readers with the latest clinical and basic research, and informed opinions that shape today''s orthopedic practice, thereby providing an opportunity to practice evidence-based medicine. With contributions from leading clinicians and researchers around the world, we aim to be the premier journal providing an international perspective advancing knowledge of the musculoskeletal system. JCOT publishes content of value to both general orthopedic practitioners and specialists on all aspects of musculoskeletal research, diagnoses, and treatment. We accept following types of articles: • Original articles focusing on current clinical issues. • Review articles with learning value for professionals as well as students. • Research articles providing the latest in basic biological or engineering research on musculoskeletal diseases. • Regular columns by experts discussing issues affecting the field of orthopedics. • "Symposia" devoted to a single topic offering the general reader an overview of a field, but providing the specialist current in-depth information. • Video of any orthopedic surgery which is innovative and adds to present concepts. • Articles emphasizing or demonstrating a new clinical sign in the art of patient examination is also considered for publication. Contributions from anywhere in the world are welcome and considered on their merits.