What is Proximal Tibial-Fibular Subluxation/Dysfunction?

The proximal tibiofibular joint (PTFJ), situated just below the knee joint, plays a crucial role in distributing rotational stress from the ankle and transmitting axial loading force from the body to the lower leg. Comprising the articulation between the tibia and fibula, this micro joint is often overlooked in studies focusing on knee biomechanics despite its significant contribution to overall joint stability.Hence many knee problems associated with trauma or infection can affect the PTFJ to dysfunction.

Traditionally, computational models of the knee have primarily focused on the biomechanical effects of major ligaments such as the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial and lateral collateral ligaments, and the role of the menisci in maintaining joint stability. However, few studies explore the role of the PTFJ within these models, which encompass bone, cartilage, ligaments, and menisci in three-dimensional representations.

Whilst many anatomical and biomechanical studies have been performed on the function of the fibula, interosseous membrane and lateral malleolus (lateral side of ankle), concerning ankle stability, the PTFJ has often been neglected. Consequently, isolated injuries to the PTFJ are poorly described in the existing research literature, leading to gaps in our understanding of its pathophysiology and clinical significance.

Despite its relative obscurity, dysfunction of the PTFJ can have profound implications for knee health, potentially contributing to chronic pain and instability if left untreated. Timely diagnosis and treatment of PTFJ dysfunction can help prevent prevention of chronic knee pain and instability.

Toropchyn, V., Kumar, S. and KUMAR, S., 2023. Proximal Tibiofibular Joint Dysfunction as a Cause of Persistent Knee Pain After Total Knee Arthroplasty: A Case Series and Literature Review. Cureus, 15(2)

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