Posteromedial Tibiofemoral Incongruence (PMTFI) Treatment

The aim of this study is to assess outcomes of Posteromedial Tibiofemoral Incongruence (PMTFI) Treatment by the means of published technique (reference nr 1).

A decrease in the posterior curvature of the femoral metaphysis close to the medial femoral condyle is one of the anatomical alterations that can be seen within the knee joint. When the knee is fully flexed, this curve is typically concave enough to accommodate the posterior horn of the medial meniscus (PHMM). Similar to cam incongruence in the hip joint, a decrease in curvature may cause posteromedial tibiofemoral incongruence, a condition marked by compression of the PHMM in complete knee flexion. If deep knee flexion occurs, clinical symptoms may appear, and PHMM degeneration may be shown to worsen over time. Surgery may be recommended for patients for whom activity modification and conservative therapy have failed. Our team proposed an arthroscopic procedure that allows for the least amount of correction that is still necessary while also providing final intraoperative confirmation of the clinical need to repair posteromedial tibiofemoral incongruence.

Inclusion criteria

• Pain, snapping or discomfort in posterior part of the knee in deep knee flexion during squat
• Reduced concavity of the femoral metaphysis proximal to the medial femoral condyle confirmed on MRI
• Impingement of posterior horn of medial meniscus with the metaphysis of femur during full knee flexion confirmed arthroscopically

Exclusion criteria

• Active knee inflammation
• Chondral injuries ICRS 3-4
• Extraarticular reasons of pain, snapping or discomfort in posterior part of the knee in deep knee flexion during squat
• Cyst or avascular changes within the femoral metaphysis adjacent to the planned localization of the procedure