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In total knee arthroplasty, the top of fibular head sometimes has to be resected simultaneously during cutting tibial plateau. Therefore, tibial plateau-fibular head distance was measured in the 244 normal knees of 125 Japanese volunteers (80 men, 45 women), with average age of 27 years ranging from 21 to 40 years. Tibial plateau-fibular head distance was measured using lateral view of knee roentgenogram. The average distance was 6.1 +/- 2.5 mm in men (range, -0.5 to 12.5 mm), and 4.7 +/- 2.6 mm in women (range, -2.5 to 12.0 mm), which was thinner than that of tibial component of conventional knee prosthesis (6-8 mm or over). The relatively high level of fibular head in Japanese may disturb proper positioning of tibial component and transmit load to tibial component in weight bearing, resulting in gradual medial tilting of the tibial component. Resection of either a tip of the fibular head or a segment of the shaft may solve this problem.