Abstract: Background: Knee osteoarthritis (OA) is a major cause of pain, disability and impaired quality of life. Technically demanding procedures like Total knee replacement and proximal tibial osteotomy are the main stay of treatment of severe OA knee. In 2015, Yang ZY et al. Reported Proximal Fibular osteotomy (PFO) as a novel procedure that is simple, relieves pain and also corrects varus deformity in medial compartment osteoarthritis. Hence, we aimed to study the outcome of proximal fibular osteotomy in management of severe medial compartment OA knee.
Materials and Methods: Our study is a prospective analysis on 40 patients, aged 42 to 76 years with moderate to severe medial compartment osteoarthritis, treated with PFO. The patients were evaluated for 12 months for using AKSS Score and VAS for pain. Radiological parameters like medial compartment space and femoro-tibial angle measured to estimate deformity correction.
Results: Significant improvement was seen in mean KSS score. KSS function score improved from an average of 53 to 77 post operatively. VAS score for pain improved from 7.5 to 3. Lateral angle at femoro - tibial axis changed from182.4 pre-operatively to 179.6 at 12 months follow up. There was improvement in range of motion and ability to squat cross legged.
Conclusion: Our study showed promising results for PFO with improved pain and range of motion in the affected knee. PFO is a technically simple procedure that can be made available to patients with debilitating OA knee at primary centers of health care. The studies available show it to be an effective therapy in Uni-compartmental OA knee. If similar results are obtained in large scale randomized control trials, PFO can emerge as an alternative for patients unable to undergo TKR due to comorbidities or economic constraints.
