Proximal tibiofibular joint

Last revised by Yuranga Weerakkody on 16 Oct 2021

The proximal (or superior) tibiofibular joint is a synovial joint between the superior aspects of the tibia and fibula and is one of the multiple sites of cartilaginous and fibrous articulation carrying the name of the tibiofibular joint.

  • fibula: flat facet of the fibular head
  • tibia: posterolateral aspect of the lateral tibial condyle
  • forms a plane-type synovial joint
  • popliteus tendon runs posterior to joint
  • popliteus bursa separates popliteus tendon from lateral tibial condyle (communicates with the tibiofibular synovial cavity)
  • biceps femoris tendon inserts into the fibular head
  • branches of inferior lateral genicular and anterior tibial recurrent arteries
  • branches of the common fibular nerve and the nerve to the popliteus
  • variable synovial communication between superior tibiofibular joint and the knee joint (10-60%) 1
  • oblique or horizontal-type morphology 3
  • reduction of rotational stress
  • prevention of lateral bending of the tibia
  • spreading axial loads when standing

Subtle proximal dislocations can be missed on plain film imaging. Lateral films may best demonstrate joint incongruity. Comparison with the contralateral knee on CT or plain film may improve detection. A high index of suspicion is required, and MRI is an often utilized modality.

  • it is rare to have an isolated joint injury to the superior tibiofibular joint
  • more commonly occurs in conjunction with other ligamentous or osseous pathologies
  • in multi-ligamentous knee injuries, superior tibiofibular joint integrity is required to ensure the success of fibular head-based posterolateral corner knee reconstruction
  • a contributor to chronic lateral knee pain and fibular nerve palsy in missed injuries
  • occurs as a result of significant rotational/twisting stress applied to the knee
  • anterolateral dislocation most common: occurs secondary to ankle inversion and plantar flexion with resultant rotation of knee joint.

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Cases and figures

  • Case 1: dislocated prox tibiofibular joint
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  • Case 2: horizontal-type
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