Joint back in trouble, disreputable ultimately (4)
I believe the answer is:
knee
'joint' is the definition.
(knee is a kind of joint)
'back in trouble disreputable ultimately' is the wordplay.
'ultimately' says to take the final letters.
The final letters of 'back in trouble disreputable' are 'KNEE'.
(Other definitions for knee that I've seen before include "Flexible joint" , "Lower limb joint" , "Human joint" , "Capped joint?" , "Thigh/shin connector" .)