{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T12:52:57Z","timestamp":1783947177460,"version":"3.55.0"},"reference-count":23,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2022,5,18]],"date-time":"2022-05-18T00:00:00Z","timestamp":1652832000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2022,5,18]],"date-time":"2022-05-18T00:00:00Z","timestamp":1652832000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2022,5,18]],"date-time":"2022-05-18T00:00:00Z","timestamp":1652832000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Instability of the proximal tibiofibular joint (PTFJ) can be treated with bicortical suspension (BCS) fixation. However, the ideal location, orientation, and configuration to apply one or two BCS devices are not clear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A finite\u2010element model of the PTFJ was created from a female adult\u2019s CT dataset. Anterior and posterior ligaments at the PTFJ were modeled and suppressed to simulate stable and unstable joints. Fifty\u2010six models simulated 56 device placements along guiding tunnel lines that connect eight entry locations on the fibular head to seven exit points on the anteromedial tibia. Doubling device stiffness created 56\u00a0more models. Combing any two placements created 1176 double\u2010device configurations which were categorized to be crossed, divergent or parallel. Displacement of the fibular head relative to the fixed tibia under 100\u00a0N anterolateral and posteromedial forces was assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Different placements had 2.1\u201327.9\u00a0mm translation with 0.7\u20138.9\u00b0 internal rotation under anterolateral loading, and 1.8\u20135.2\u00a0mm translation with 6.1\u20137.9\u00b0 external rotation under posteromedial loading. More transverse and superior orientations were associated with smaller anterolateral translation; more posterior and superior entry locations were associated with smaller internal rotation. The median (IQR) reductions in anterolateral translation by doubling device stiffness and by adding a second device were 0.8 (IQR 0.5\u20131.0) and 0.8 (IQR 0\u20136.1) mm, respectively. The type of double\u2010device configurations had no significant effect on fibular motion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Surgeons should drill the guiding tunnel superiorly and transversely to ensure the optimal restoration of the PTFJ anterolateral stability.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-022-06991-8","type":"journal-article","created":{"date-parts":[[2022,5,18]],"date-time":"2022-05-18T12:18:28Z","timestamp":1652876308000},"page":"3767-3775","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Superiorly and transversely orienting the bicortical suspension device provides optimal anterolateral stability to the proximal tibiofibular joint: a finite\u2010element study"],"prefix":"10.1002","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4819-6893","authenticated-orcid":false,"given":"Shangcheng","family":"Wang","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery Atrium Health Musculoskeletal Institute 1000 Blythe Blvd 28203 Charlotte NC USA"},{"name":"<!--<label>3<\/label>--> OrthoCarolina Research Institute Charlotte NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nahir","family":"Habet","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery Atrium Health Musculoskeletal Institute 1000 Blythe Blvd 28203 Charlotte NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivia M.","family":"Rice","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery Atrium Health Musculoskeletal Institute 1000 Blythe Blvd 28203 Charlotte NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tyler L.","family":"CarlLee","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> OrthoCarolina Sports Medicine Charlotte NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"III","given":"Claude T.","family":"Moorman","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery Atrium Health Musculoskeletal Institute 1000 Blythe Blvd 28203 Charlotte NC USA"},{"name":"<!--<label>2<\/label>--> OrthoCarolina Sports Medicine Charlotte NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,5,18]]},"reference":[{"key":"e_1_2_11_2_2","first-page":"134","article-title":"The visible human project","volume":"288","author":"Ackerman MJ","year":"2022","journal-title":"Stud Health Technol 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Author Claude T. Moorman III is a speaker bureau for Lipogems, a paid consultant to DJ Orthopedics & OsteoCentric. He owns stock or stock options in the following companies\/suppliers: OsteoCentric and PRIVIT. He has received research support from the following companies\/suppliers: ZetrOZ, HeadTrainer, HistoGenetics, and Tornier. He has received fellowship support from the following companies\/suppliers: Arthrex and Smith & Nephew. He has received royalties from Prager and World Scientific. He has served on medical\/ortho publications editorial\/governing boards for the following: Sage Pub and JSOA\/Data Trace. He has society board member and committee appointments in the following organizations: American Orthopedic Society for Sports medicine, NC High School Athletic Association, and Piedmont Orthopedic Society.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"No approval was needed.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"No consent was required.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent"}}]}}