Radiological evaluation of the proximal tibiofibular joint in knees with severe primary osteoarthritis

Abstract

The proximal tibiofibular joint (PTFJ) can be considered to be the fourth compartment of knee joint. Although degenerative diseases of the knee joint may also have detrimental effects on the PTFJ until now, details of arthritic affection of PTFJ in the elderly who have severe femorotibial arthritis have not been described. Convenience samples of knees of elderly patients with Kellgren-Lawrence grade III-IV primary osteoarthritis were investigated further in order to determine the X-ray findings of PTFJ. Sixty knees in 34 patients with an average age of 71 years (61-86 years) were examined. Both knees were examined in 26 patients. On the radiographs, 23 joints were grade IV, 14 were grade III, and 23 were grade II. At most, only minor differences were seen between knees on the same patient in terms of lower extremity alignment, grade of TFJ degeneration, grade of PTFJ degeneration, and type of PTFJ. Interobserver correlation was good for radiographic evaluation of PTFJ (kappa = 0.557). By intraobserver analysis with McNemar test, there was no statistically significant difference between the radiographic evaluations of PTFJ (p = 0.167). Arthritic grades of PTFJ and tibiofemoral joints were strongly correlated (Pearson coefficient r = 0.58, p < 0.001). No significant relation was found between type of PTFJ and grade of arthritis (chi(2) test, p = 0.42). In the light of these findings, the proximal tibiofibular joint should be evaluated for arthritic findings that may be responsible for lateral knee pain before a total knee arthroplasty operation is considered. The type of PTFJ is not related to the degree of this joint arthritis.

Varus Di̇zi̇li̇m Bozukluğu Ve Pri̇mer Osteoartrozlu Di̇zlerde Total Di̇z Protezi̇ Sonrasi Proksi̇mal Ti̇bi̇ofi̇bular Kaynakli Ağri Hasta Mutsuzluğuna Neden Mi̇?

“…It seems oblique PTFJs are prone to degenerative changes. Results supporting or rejecting this idea have been reported in different studies (2,3).…”

“…Therefore, the joint is especially important in patients with TKA. A few reports about primary osteoarthritic involvement of this joint have been published (2,3,20,21).…”

“…Also, the radiologic degree of osteoarthritis in PTFJ correlates strongly with the degree of arthritis in TFJs with severe degenerative joint disease (DJD) and varus malalignment (3). An anatomical communication between these joints, reported to be 10-63%, can be held responsible for the similar level of osteoarthritic involvement (1,17,18,22).…”

A 17 year old with isolated proximal tibiofibular joint arthritis

“…The most common cause for pain at this site is recurrent traumatic TFJ subluxation/dislocation, often seen with high-impact activities and which can result in bone marrow edema or other radiographic signs suggestive of inflammation [2,10]. The differential diagnosis of pain in this area should include infection, chronic arthritis (such as in rheumatoid arthritis), degenerative disease, neoplasm (e.g.…”

Proximal Tibiofibular Joint in Knees with Arthroplasty

“…The degree of osteoarthritis of the proximal tibiofibular joint strongly correlates with the degree of arthritis www.intechopen.com in tibiofemoral joints (TFJ) that have severe degenerative joint disease (Boya et al, 2008). Inflammatory enzymes passing between the joint spaces through possible anatomical communication between the TFJ and PTFJ may contribute to the advancement of arthritis in the respective compartments (Boya et al, 2008;Bozkurt et al, 2003).…”