The Journal of Bone and Joint Surgery, Vol 73, Issue 4 575-583, Copyright © 1991 by Journal of Bone and Joint Surgery, Inc
The effects of resection of the proximal part of the fibula on stability of the knee and on gait
LF Draganich, RW Nicholas, JK Shuster, MR Sathy, AF Chang and MA Simon
Department of Surgery, University of Chicago, Illinois 60637.
We studied six patients to determine the effects of unilateral marginal
resection of the proximal part of the fibula on stability of the knee and
on gait. At the time of the operation, the fibular collateral ligament and
the tendon of the biceps femoris were reattached, but no attempt was made
to stabilize the fibula otherwise. The patients were tested an average of
sixty-one months after operation. Stability of the knee was measured with
an instrumented system. Gait was evaluated with an optical electronic
three-dimensional digitizing system and a multicomponent force-platform.
The gait of six healthy control subjects of similar age was also studied,
and the reproducibility of measurements of stability of the knee was
investigated in four healthy adults. There were significant differences
between the side on which an operation had been done and the contralateral
side with regard to the extent of anterior translation and of total
anterior-posterior translation of the tibia at both 20 and 90 degrees of
flexion of the knee, and in total varus and valgus rotation of the knee
(the number of degrees from a position of maximum varus to one of maximum
valgus angulation) at 20 degrees of flexion. The measurements of gait and
of motion of the knee were found to be normal when compared with those in
the control subjects. In the ground-reaction measurements, there were some
significant differences from normal in the medial-lateral plane, but they
were clinically unimportant. Resection of the proximal part of the fibula
can lead to instability of the knee.
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