Modified Reconstruction of The Proximal Tibiofibular Joint Using Iliotibial Band: A Case Report

Abstract

Introduction: Instability of the proximal tibiofibular joint is a rare condition and may present with an atypical presentation due to its location and symptoms. Recent techniques and graft has allowed to repair tibiofibular joint. Iliotibial band autograft might be used as a choice for this case as its characteristic, cost effectiveness, minimal invasive graft harvesting procedure, and long term outcome bring consideration to use as choice for the treatment. Objective: To introduce the new technique for PTFJ instability by using ITB graft Case report: A 21-year-old office worker male came to our clinic with discomfort on lateral aspect of right knee. He injured his right knee after he externally twist his right knee when he was going to wake up (stand up) from bed. He experienced immediate lateral pain and swelling lateral knee pain persisted until 1 week before admitted to the hospital. Discussion: In our case, patient is a office worker without an adequate energy cause the joint becoming sublux. For the surgical technique , we took the graft form the center side of ITB with the intentional purpose of preventing Kaplan Fiber. For the reaming procedure we took place directly behind the fibula and keep the posterior capsule intact to prevent further damage and infection on surgical site. We choose to use biomaterial implant for this study because the use of biomaterial screw itself has a low complication rate compare to metallic screw with no significant different in outcome (6). This technique overall has a satisfaction result with improvement of Lyshom score Conclusion: Iliotibial band is an alternative graft that can be used for reconstruction in tibiofibular joint. For its minimal invasive technique and cost effectiveness and satisfy long term outcome coud be a consideration for the treatment in tibiofibular instability.