DOES PROXIMAL TIBIOFIBULAR JOINT MEDIATED PAIN MAKE PATIENTS UNHAPPY AFTER TOTAL KNEE ARTHROPLASTY IN KNEES WITH PRIMARY OSTEOARTHRITIS AND VARUS MALALIGNMENT?

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OBJECTIVE: Presence of a clinical correlation has notbeen demonstrated between tibiofemoral joint (TFJ) andproximal tibiofibular joint (PTFJ) in knees with severe osteoarthritis.The purpose of this retrospective study is toclinically evaluate PTFJ in patients with total knee arthroplasty(TKA) performed for end-stage primary osteoarthritiswith genu varum deformity.MATERIALS AND METHODS: Patients with TKA performedfor severe osteoarthritis with genu varum deformitywere retrospectively evaluated. Relationships betweenPTFJ clinical examination findings and PTFJ type, hamstringtightness, and lateral joint line (LJL) tenderness wereinvestigated using the chi-square test. Also, descriptivestatistics were used.RESULTS: Fifty-four patients (five male and 49 female;mean age 62.7 years; range 46-81 years) constituted thestudy group. Both knees were operated in 30 (55.6%) patients.Average follow-up period was 21.6 months (range12-49 months). PTFJ tenderness, hamstring tightness,and LJL tenderness were established in six (7.1%), four(4.8%), and six (7.1%) knees, respectively. There were six(7.1%) knees with horizontal type PTFJ and 78 (92.9%)knees with oblique type PTFJ. PTFJ tenderness was determinedin knees with oblique type PTFJ (chi-square test,p=0.000), knees with LJL tenderness (chi-square test,p=0.000), and knees with hamstring tightness (chi-squaretest, p=0.000).CONCLUSIONS: PTFJ does not seem to be the exact sourceof lateral knee pain after TKA operations in knees withsevere degenerative joint disease and varus malalignment.However, it should be considered that oblique-typePTFJ may have the potential to create pain in these knees.

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Proximal tibiofibular joint , Total knee arthroplasty , Lateral knee pain , Osteoarthritis

Kocatepe Medical Journal

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Kocatepe Medical Journal