Oğuz KAYA, Muhammed KAZEZ, Ali Sami ŞEKER
Baltalimanı Dergisi - 2025;1(2):44-47
Objective: Proximal tibiofibular joint (PTFJ) dislocation is one of the causes of lateral knee pain and is very rare. The bilateral form, and especially when idiopathic, is even more uncommon. This study presents the first true bilateral idiopathic PTFJ dislocation reported in the literature. The case report also includes a literature review and provides discussion on surgical approaches. Methods: A 16-year-old female patient presented with lateral pain, clicking sound, and a feeling of discomfort in both knees during flexion and extension. No history of trauma or connective tissue disease was identified. On physical examination, tenderness and abnormal movement were observed in both fibular heads. Peroneal nerve examination was normal. Direct radiographs revealed asymmetry at the level of the fibular heads, and MRI showed increased fluid accumulation and minimal synovial changes in both proximal tibiofibular joints. Since symptoms persisted despite previous conservative treatments, surgical intervention was planned. To preserve the functional stability of the joint, a tunnel was opened from the lateral posterior of the fibula to the anteromedial of the tibia, and fixation was performed using a suture-button suspension system. Results: Postoperative radiographs confirmed proper alignment and joint stability. The patient achieved full recovery without pain, instability, or neurological deficit at the 12-month follow-up. Conclusion: Bilateral idiopathic PTFJ dislocation is an extremely rare condition that is difficult to diagnose and requires a high degree of clinical suspicion. Detailed physical examination and advanced imaging methods such as MRI play a critical role in diagnosis. While conservative treatment may be effective in stable and neurologically asymptomatic cases, surgical intervention may be necessary in the presence of instability or recurrence. The suture-button technique may be an effective option due to its minimally invasive nature and advantage in preserving functional stability.
