Proximal tibiofibular joint reconstruction with autogenous semitendinosus tendon graft

Isolated and chronic anterolateral instability of the proximal tibiofibular joint (TFJ) is an uncommon condition, generally linked to an unrecognized or unhealed dislocation of the TFJ. Clinically, abnormal anterior movement of the head of the fibula is detected. In acute injuries conservative management should be preferred, whereas surgical treatment have been advocated in patients with chronic TFJ instability. Authors describe a new surgical reconstruction technique for chronic instability of the proximal TFJ using an autogenous semitendinosus tendon. The graft is passed through fibular and tibia tunnels and fixed with 2 interference screws. The tibial tunnel is reamed from the posterolateral side of the tibia to the anteromedial aspect of the tibia, exploiting the previously skin incision used for tendon harvest. The technique proved to be safe and effective to stabilize the proximal TFJ. © 2013 by Lippincott Williams & Wilkins.