A study of functional outcome of proximal fibular osteotomy in medial compartmental osteoarthritis of knee

Abstract

Objective: To evaluate the effectiveness of proximal fibular osteotomy (PFO) to produce symptomatic relief from pain and improvement of medial joint space and function in patients with medial compartmental osteoarthritis of the knee. Materials and Methods: A prospective study from October 2019 to October 2021 at Rajah Muthiah Medical College, in 15 patients with clinical and radiological evidence of osteoarthritis of knee (Kellgren and Lawrence score 2 or more) who surgically managed with proximal fibular osteotomy were used in this study. Preoperative and Postoperative weight-bearing x-rays were obtained, to measure tibiofemoral angle, medial and lateral joint space of knee and to analyse the alignment of lower extremity. Pain relief was measured using a visual analogue scale and functional recovery was assessed by using the oxford knee score preoperatively and postoperatively. Results: PFO provides short-term relieving from knee pain and improvement in walking postoperatively in almost all patients. Postoperative weight-bearing radiographs showed an increase in medial joint space and obvious correction of alignment of the lower extremity. Conclusion: PFO is a technically easy and simple procedure in treating unicompartmental osteoarthritis of the knee, provides significant pain relief and functional restoration of the joint. PFO can emerge as an alternative for younger patients with medial compartmental arthritis and patients unable to undergo TKR due to comorbidities. This surgery delays the need for a TKR, even may obviate it. Care should be taken to avoid common peroneal nerve injury.