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Successful Fusion of the Proximal Tibiofibular Joint with Osteogenic Protein-1 (OP-1) Augmentation

  • Case Report
  • Published:
HSS Journal ®

Abstract

Proximal tibiofibular joint (PTFJ) instability is rare, but when encountered can be difficult to manage. Previously reported forms of treatment, including cast immobilization, soft tissue repairs and reconstructions, and fibular head resection have met with limited success. Another option is PTFJ arthrodesis—however, fusion can be difficult and ankle pain after surgery is not uncommon. In this report, we present a novel surgical technique used to treat PTFJ instability. It is a form of PTFJ arthrodesis that utilizes the osteoinductive agent recombinant human osteogenic protein (rhOP-1) to help achieve fusion, in conjunction with a fibular osteotomy to unload the PTFJ and to preserve normal rotator mobility of the distal fibula during ankle motion. We have used this technique in two patients with successful results; one of whom required revision after two previous failed attempts at PTFJ fusion and the other who had a previous diagnosis of underlying collagen disorder. Their case studies are presented in detail in this report.

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Disclosures

Each author certifies that he or she has no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted.

Each author certifies that his or her institution has approved the reporting of these cases, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participating in the study was obtained.

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Authors and Affiliations

  1. Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA

    Demetris Delos M.D. & Scott Rodeo M.D.

  2. Department of Orthopaedics and Sports Medicine, University of Washington-Harborview Medical Center, Seattle, Washington, 98195, USA

    Jason Schneidkraut M.D.

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  1. Demetris Delos M.D.
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  2. Jason Schneidkraut M.D.
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  3. Scott Rodeo M.D.
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Correspondence to Demetris Delos M.D..

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Delos, D., Schneidkraut, J. & Rodeo, S. Successful Fusion of the Proximal Tibiofibular Joint with Osteogenic Protein-1 (OP-1) Augmentation. HSS Jrnl 9, 90–95 (2013). https://doi.org/10.1007/s11420-012-9271-2

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  • DOI: https://doi.org/10.1007/s11420-012-9271-2

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