Online ISSN: 2515-8260

Keywords : Proximal Fibular Osteotomy


Paramesha K C , Nitin N Sunku, Raghavendra J

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 6, Pages 673-680

BACKGROUND: Osteoarthritis (OA) is the most prevalent type of arthritis in the world. With the progressive aging of the population, it is becoming a major problem of public health. Symptomatic Knee osteoarthritis (OA) is chronic, progressive degenerative joint disease with accompanying pain, stiffness, and deformity of the knee joint. Osteoarthritis is the most frequent joint disease with a prevalence of 22% to 39% in India. OBJECTIVE: To evaluate the pain relief and  radiological improvement in medial joint space following proximal fibular osteotomy in medial compartment knee osteoarthritis. METHODS: From November 2018 to May 2020, 25 patients (four cases were bilateral so total of 29 knees) who underwent proximal fibular osteotomy for medial compartment osteoarthritis in teaching hospitals attached to Bangalore Medical College & Research Institute, were followed up. Preoperative and postoperative weightbearing and entire lower extremity X-rays were obtained to analyze the alignment of the lower extremity and ratio of the knee joint space (medial/lateral compartment). Functional assessment was done using Visual Analogue Scale (VAS) & American Knee Society Score. (KSS). RESULTS: A total of 25 patients and 29 knees were followed-up. Of these, 6 were male and 19 were female patient. The average age was 58.72 years. The average preoperative VAS score, KSS clinical & KSS functional score were 6.75 points, 40.31 points & 44.82 respectively. According to KL grading, there were 20 knees of grade 2 and 9 knees of Grade 3. The average postoperative VAS score, KSS clinical & KSS functional score were 2.34 points, 76.79 points & 76.72 points respectively. The medial joint space has improved significantly from a preoperative value of 1.22 mm to postoperatively 3.71 mm. The ratio of medial to lateral joint space improved from a preoperative value of 0.20 to 0.67. CONCLUSION: Patients who underwent Proximal Fibular Osteotomy showed statistically significant improvement in functional & radiological outcome at 6 months follow up. We conclude by stating that PFO is an attractive option for pain relief in patients with medial compartment osteoarthritis of knee. The procedure is simpler, effective, and easy to perform. It is less expensive and requires lesser rehabilitation than alternative procedures like HTO, UKA & TKA. It gives excellent pain relief postoperatively & is associated with fewer complications

Functional outcomes of proximal fibular osteotomy in osteoarthritis knee grade II & III

Govind Pratap Singh, Bhupinder Singh Brar, Dr. Punit, Navneet Singh, Sandeep Singh Jaura

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 1059-1066

Introduction: Osteoarthritis of the knee is a degenerative condition with a variety of treatment options like high tibial osteotomy (HTO), arthroscopic debridement, unicompartmental knee arthroplasty and total knee arthroplasty. This study was conducted with an aim to assess the outcomes of individuals with Grade II and III medial compartment osteoarthritis treated with a proximal fibular osteotomy (PFO) to alleviate discomfort, improve medial joint space and function of the knee joint.
Methodology: From November 2019 to October 2021, 25 Patients aged 45 to 65 years with knee OA of grade II or III (Kellgren-Lawrence classification) involving the medial compartment of the knee were included and underwent proximal fibular osteotomy and were followed up. Preoperatively as well as postoperatively, the entire lower extremity radiographs were obtained to assess the alignment of the lower extremity and the ratio of the knee joint space (medial/lateral compartment), knee pain was assessed using a visual analogy scale and knee ambulation activities were assessed using the American Knee Society score.
Results: All patients experienced alleviation from medial knee discomfort postoperatively. Postoperative weight-bearing lower limb radiographs revealed an average increase in medial knee joint space. The mean preoperative AKSS improved from 43.92 to 63.88 till the last follow-up.
Conclusion: PFO is a safe, simple and effective procedure that significantly decreases knee discomfort. It also enhances the joint's radiographic appearance and functional outcome in patients with medial compartment osteoarthritis of the knee.

Functional outcome of proximal fibular osteotomy in medial compartment osteoarthritis knee

Dr. Sachin K, Dr. Harshavardhan BR, Dr. Venu Madhav HV

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 12037-12043

Knee osteoarthritis (OA) being the commonest joint disease has an incidence of 30% in population above 60 yrs. Proximal Fibular osteotomy (PFO) though in exploratory stage has aroused lot of interest in orthopedic surgeons as it seems to be most simple, affordable, safe surgery without any insertion of implants. A prospective study based on 30 knees with medial compartment knee osteoarthritis treated surgically in department of Orthopaedics for a period of 2 years. The data was collected using structured proforma, consent and functional outcome analysed based on Visual Analogue Score and American Knee Society Score. They were evaluated using Visual Analogue Score which was decreased from pre op 7.52 to post op 3.2 and American Knee Society Score which improved from pre op 44.9 to post op 74.1 where Good outcome was found in 23 knees (76.6%), excellent outcome was found in 3 knees (10%), fair outcome was observed in 4 knees (13.33%). Only 2 out of 30 knees had EHL weakness as complications which eventually recovered completely by end of 12 months.