title: Is superior tibiofibular joint resection necessary in extraarticular knee resection for sarcomas? A systematic review.
abstract: BACKGROUND
  Sarcomas infiltrating the knee joint require extraarticular resection to achieve wide margins. Opinions differ as to whether the superior tibiofibular joint (STFJ) is part of the knee joint and should be removed in the course of extraarticular resection. Thus, we investigated the frequency of communication between the tibiofemoral joint (TFJ) and the STFJ, and the reported local recurrence rates (LRR) following extraarticular knee resection.
  
  
  METHODS
  A systematic literature review on STFJ and TFJ communication and local recurrence rates following extraarticular knee resections was undertaken.
  
  
  RESULTS
  Cadaver studies detected communication between the TFJ and STFJ in 10-64% of the cases. Direct arthrography with physical loading verified a 100% communication rate. Regarding the extent of extraarticular knee resection, two institutions where the STFJ was resected had a LRR of 4-8%, while studies from another three where the STFJ was not routinely resected reported a LRR of 0-21%.
  
  
  CONCLUSIONS
  Since the literature reports about a 100% communication rate between the TFJ and the STFJ, resection of the STFJ in patients with sarcomas involving the knee joint would seem to be indicated, although it is not clear whether resection of the STFJ reduces local recurrence rates.
authors: Department of Orthopedics and Orthopedic Surgery, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, Austria. magdalena.gilg@outlook.com.
authors: Magdalena M
authors: MM
authors: Gilg
authors: Department of Orthopedics and Orthopedic Surgery, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, Austria. christine.wibmer@medunigraz.at.
authors: Christine
authors: C
authors: Wibmer
authors: Department of General Orthopedics and Tumor Orthopedics, University Hospital of Muenster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Münster, Germany. dimosthenis.andreou@ukmuenster.de.
authors: Dimosthenis
authors: D
authors: Andreou
authors: Department of Orthopedics and Orthopedic Surgery, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, Austria.
authors: Patrick
authors: P
authors: Sadoghi
authors: Department of General Orthopedics and Tumor Orthopedics, University Hospital of Muenster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Münster, Germany. georg.gosheger@ukmuenster.de.
authors: Georg
authors: G
authors: Gosheger
authors: Department of Orthopedics and Orthopedic Surgery, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, Austria. andreas.leithner@medunigraz.at.
authors: Andreas
authors: A
authors: Leithner
mesh_terms: D006801:Humans; D007719:Knee Joint / Q000473:pathology / Q000601:surgery*; D011379:Prognosis; D012509:Sarcoma / Q000473:pathology / Q000601:surgery*