Weinert and Giachino ligament arthroplasty for the surgical treatment of chronic superior tibiofibular joint instability

Abstract

Recurrent dislocations of the superior tibiofibular joint are rare. The majority of these patients are physically active, young adults. Different surgical techniques have been described for the management of this pathology: resection of the proximal aspect of the fibula, arthrodesis of the superior tibiofibular joint with or without fibular osteotomy. Because of the problems reported with these techniques, we opted for Weinert and Giachino ligament reconstruction. From 1989 to 1994, three patients were treated and reviewed in our practice: all, soccer players on the local team, 20, 23, and 25 years old, with superior tibiofibular pain and tumefaction, without neurological symptoms, but with anteroposterior mobility of the fibular head. The average duration of the symptoms before operation was 9 months, and the average follow-up was 15 months. At the follow-up, pain and anteroposterior mobility were gone. Soccer playing was resumed at 7 months without recurrence but with low frequency and stress. In our opinion, the Weinert and Giachino ligament reconstruction, using a portion of the biceps tendon to reconstruct the superior tibiofibular ligament, appears an effective approach to restore indolence and stability to the superior tibiofibular joint and to avoid complications of resection and arthrodesis.