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Dr Caron is from the Functional Rehabilitation Department, Life University, Center for Health and Optimum Performance, Marietta, Georgia.
The author has disclosed no potential conflicts of interest, financial or otherwise.
Proximal tibiofibular joint (PTFJ) dysfunction can mimic a lateral meniscus tear, and it is easily overlooked. Common symptoms include the inability to bear weight and swelling and point tenderness of the lateral aspect of the knee. This article describes the evaluation for PTFJ dysfunction and mobilization techniques used to correct fixations.
The PTFJ consists of the lateral condyle of the tibia, fibular head, articular capsule, anterior and posterior tibiofibular ligaments, and a thin, fibrous ligamentous structure that connects the lower border of the lateral meniscus to the fibular head. The muscles that attach to the fibular head are the biceps femoris and the popliteus tendon.1
Movement of the fibula is essential to the lower-leg kinetic chain, transmitting forces between the knee and the ankle. During internal and external rotation of the tibia, the fibular head will translate 1 to 3 mm anteriorly and posteriorly. Anterior translation of the fibular head is coupled with internal rotation of tibiofemoral joint, whereas posterior translation accompanies external rotation. It is postulated that fibular translation acts as a shock absorber during torsional stress. Slight superior-inferior movement (averaging less than 1 mm) augments the shock-absorbing capabilities of this joint.2
The most common mechanism...