Is Stability of the Proximal Tibiofibular Joint Important in the Multiligament-injured Knee?

Jabara, Michael; Bradley, Jeffrey D.; Merrick, Michael

doi:10.1007/s11999-014-3574-1

Cited by 44 publications

(42 citation statements)

References 28 publications

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“…Correlation with Lysholm scores ranged from 0.65 to 0.93, suggesting measurement of similar constructs 18 19 28. Correlation with Tegner activity scores was 0.56 in one study, suggesting measurement of a separate activity-related construct 28.…”

Section: Resultsmentioning

confidence: 89%

KOOS and IKDC scales may be inadequate in evaluating patients with multiple ligament knee injuries: a systematic review

et al. 2016

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Section: Resultsmentioning

confidence: 89%

KOOS and IKDC scales may be inadequate in evaluating patients with multiple ligament knee injuries: a systematic review

et al. 2016

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“…Besides proximal tibiofibular joint disruption, asymmetric hyperextension of the injured knee is often used as an indicator to use a "twotailed" technique. 18,19 Currently, clinical outcome studies are sparse and have not demonstrated a clear benefit over fibularbased reconstructions. This is likely the result of poorly defined indications with very low number patient cohorts.…”

Section: Resultsmentioning

confidence: 99%

“…A universally accepted indication for a two-tailed technique would be proximal tibiofibular joint disruption in the setting of a PLC injury. 18 Asymmetric hyperextension of the injured knee is typically an indication of the need for a two-tailed reconstruction technique. 19…”

Section: History and Physical Examinationmentioning

confidence: 99%

Posterolateral Reconstruction of the Knee: Two-Tailed Surgical Techniques

et al. 2015

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Reconstruction of the posterolateral corner of the knee using two-tailed techniques involved grafts originating from the femur and inserting on the proximal tibia and fibular head. This method reconstructs the fibular collateral ligament, popliteofibular ligament, and popliteus tendon using anatomically placed grafts. This article describes the history, anatomy, indications, and authors' preferred technique for a two-tailed posterolateral corner reconstruction. In addition, biomechanical and clinical outcomes of this technique will be compared.

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“…The cyst was not present on the initial MRI.Direct blunt force trauma to the knee has long been known to result in severe injuries to the knee causing posterolateral corner, multi-ligamentous knee, and CFN injuries. They have also been associated with instability of the STFJ (Fallon et al, 1994;Kapur et al, 2009;Jabara et al, 2014). The resultant stretch tends to affect a long segment of the CFN.…”

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confidence: 99%

Sequential MR imaging demonstrates evolution of a fibular intraneural ganglion cyst after knee dislocation

et al. 2014

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The basis for the articular (unified) theory for the formation of intraneural ganglion cysts is a capsular disruption through which joint (cyst) fluid egresses into the articular branch and then a parent nerve (Spinner et al., 2003). Trauma has been associated with intraneural ganglion cysts. A recent meta-analysis revealed trauma being associated with intraneural ganglion cysts in 12% of cases (Desy and Spinner, 2014). Our group has described the pathoanatomy by which direct and indirect trauma may give rise to the most common form, fibular (peroneal), and its rarer corollary, tibial intraneural ganglion cysts, both derived from the superior tibiofibular joint (STFJ) (Lalezari et al., 2012; Spinner et al., 2012a,b;Cesmebasi et al., 2014). In direct trauma, there would be a force generated near the proximal leg/knee region that would affect the STFJ (Ogden, 1972(Ogden, , 1974Sekiya and Kuhn, 2003); in indirect trauma, forces would be translated from the ankle region (such as in ankle sprains or fracture) via the interosseous membrane to the proximal leg (Cesmebasi et al., 2014). A direct causeeffect relationship between traumatic injury and intraneural ganglion cyst formation has yet to be definitively established.A 20-year-old man tripped off a curb and fell on his left knee. He sustained a multi-ligamentous knee injury as a result from a knee dislocation. He presented to an emergency room with exquisite pain and foot drop from a common fibular nerve (CFN) palsy and was discharged after negative plain radiographs were obtained. Several days later, he noted increasing pain and was found to have elevated leg compartment pressures for which he underwent four compartment fasciotomies. MRI performed 7 days after the initial injury revealed a posterolateral corner injury involving disruption of the fibular collateral and posterior cruciate ligaments, posterolateral capsule, and the musculotendinous junction of the popliteus, lateral meniscus, and medial patellofemoral ligament. There was edema and thickening of the CFN extending from the fibular neck to a point just distal to the sciatic nerve bifurcation (Figs. 1A-1C). He was referred to colleagues at our institution for definitive care of the multi-ligament injury and the CFN injury. Repeat MRI 3 months after the injury confirmed the previous findings referable to the ligamentous injury. The CFN was markedly enlarged in the popliteal fossa. There was anterior and lateral compartment musculature atrophy consistent with denervation. Electromyography (EMG) confirmed a complete common fibular neuropathy. He underwent staged reconstruction over the course of 9 months: (1) exploration and nerve grafting of the left CFN with 2 cable grafts (9 cm in length) using the superficial fibular nerve; (2) high tibial wedge osteotomy with allograft bone graft; and (3) multi-ligament knee reconstruction. At last follow-up, 15 months post nerve grafting, he had no return of neurologic function but had regained a stable knee. It was recommended he undergo tendon transfer for persisten...

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Is Stability of the Proximal Tibiofibular Joint Important in the Multiligament-injured Knee?

Abstract: Level IV, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.

Cited by 44 publications

References 28 publications

KOOS and IKDC scales may be inadequate in evaluating patients with multiple ligament knee injuries: a systematic review

KOOS and IKDC scales may be inadequate in evaluating patients with multiple ligament knee injuries: a systematic review

Posterolateral Reconstruction of the Knee: Two-Tailed Surgical Techniques

Sequential MR imaging demonstrates evolution of a fibular intraneural ganglion cyst after knee dislocation

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