Role of the proximal tibiofibular joint on the biomechanics of the knee joint: A three-dimensional finite element analysis

Purpose The proximal tibiofibular joint (PTFJ) is easily ignored, although many diseases of the knee are caused by PTFJ injuries. Therefore, studying PTFJ biomechanics is very important. The effects of PTFJ injury on ankle function have been reported. However, few studies have assessed the effects of PTFJ injury on the knee joint. This study was performed to describe the biomechanical effects of PTFJ on the knee joint according to a three-dimensional finite element model. Methods The knee joint of a healthy volunteer was scanned by CT and MRI. CT and MRI scanning data in DICOM format were imported into Mimics software. Subsequently, 3D models of the normal and PTFJ injured knee, including the bone, cartilage, meniscus and ligament structures were established, and their validity was verified on the basis of available studies in literature. The biomechanical changes in the two knee models under different conditions were compared. Results The validity of the intact model was verified. No significant difference was observed in tibial mobility in the two models under the conditions of 134 N forward, 10 N·m internal rotation and 10 N·m valgus load. After application of 134 N backward, 10 N·m varus and external rotation load with respect to the tibia, the posterior movement of the tibia and the varus and external rotation angles of the tibia were 3.583±0.892 mm, 4.799±0.092° and 18.963±0.027° in the normal knee model, and 5.127±1.224 mm, 5.277±0.104° and 21.399±0.031° in the PTFJ injury model, respectively, and a significant statistical difference was observed. Conclusions PTFJ played an important role in maintaining the posterolateral stability of the knee joint and thus deserves more attention in clinical operations.