Lateral-sided pain at the knee which is associated with the proximal tibiofibular joint in patients with total knee arthroplasty

Proximal tibiofibular joint (PTFJ) is a synovial joint. Because of proximity of PTFJ and knee joint, numerous disorders of PTFJ can present as lateral knee pain. Total knee arthroplasty (TNA) is the last treatment alternative in severe primary gonarthrosis. In those cases, PTFJ may become symptomatic due to communication between both joint cavity and the disease. For this reason, the PTFJ should be carefully evaluated for osteoarthritis in patients being considered for a TNA operation. If overlooked as an etiology of a patient?s lateral knee pain, pain from PTFJ osteoarthritis may continue post-operatively.Eighty-four knees in 54 patients (49 females and 5 males; mean age 62,2 years; range 46?81 years) with severe primary gonarthrosis, varus deformity, and at least one year follow-up were enrolled in this study in order to collect clinic and radiologic data regarding PTFJ. With regard to the type of PTFJ, 6 (%7,1) joints were horizontal and 78 (%92,9) were oblique. Pain and tenderness were observed in 6 (%7,1) PTFJs upon clinical examination (6 oblique PTFJ type). Lateral hamstring tightness and lateral joint line tenderness were found in 4 (4 oblique TFJ type) and 6 knees, respectively. All PTFJs in knees with lateral hamstring tightness and lateral joint line tenderness were painful during the physical examination. A significant relationship was found between PTFJ exam findings and PTFJ type (?2 test:61,714, p=.000), hamstring tightness (?2 test:68,762, p=.000), and lateral joint line tenderness (?2 test:61,714, p=.000).PTFJ should evaluate in detail preoperatively in knees with severe primary gonarthrosis which are going to operate by TNA. PTFJs have oblique type can produce sypmtoms due to arthritis. If lateral joint line tenderness observed in knees with arthroplasty, PTFJ should evaluated.