Abstract: Background: Osteoarthritis [OA] of the knee is a chronic, progressive degenerative disease with accompanying joint pain, stiffness, and deformity. Varus deformities of the knee, characterized by a femorotibial axis of less than 180° on full-leg standing AP radiographs and narrowed medial joint space, are common in patients with knee OA. There is a growing need for Proximal Fibular Osteotomy (PFO) in LMIC, since it is simple, safe and affordable. PFO may delay or replace TKA in a subpopulation of patients with knee osteoarthritis and pain relief after surgery occurs in almost all patients.
Method: We have taken 30 patients coming to our orthopaedic OPD with predominantly medial compartment OA knee at Mahatma Gandhi Medical College & Hospital. Preoperative and postoperative weight-bearing and whole lower extremity radiographs were obtained to analyse the alignment of the lower extremity and the knee joint space. Knee pain was assessed using a visual analogue scale, and knee ambulation activities were evaluated using the American Knee Society score preoperatively and postoperatively.
Result: The preoperative KSS score was 53.56±4.606 while postoperatively it was 72.16±8.07. The preoperative KSS score was 42.16±14.72 while postoperatively it was 72.23±9.98 at functional score. Preoperatively the mean VAS score was 7.53 which significantly decreased to 3 in the postoperative period. We also noted decrease in the femoro-tibial angle from preoperative (182.73±1.79) to postoperative period (178.23±2.09) whereas in the medial joint space it was increased from 1.69±0.96 mm to 3.43±1.21 in the postoperative period.
Conclusion: The PFO is a promising surgical option in countries that lack financial and medical resources. As compared to TKA or HTO, the PFO is a simple, safe, fast and affordable surgery that does not require insertion of additional implants leading to less complications and a shorter recovery period.
