Proximal fibular osteotomy: Alternative approach with medial compartment osteoarthritis knee – Indian context

Abstract

Context: Osteoarthritis knee is a common degenerative disorder for which various treatment modalities are available. Our aim was to evaluate the functional outcome and effectiveness of proximal fibular osteotomy (PFO) in patients who are unwilling to undergo total knee arthroplasty or high tibial osteotomy (HTO). Aims: To evaluate functional outcome of medial compartment osteoarthritis managed with PFO, clinically as well as radiologically in Indian study settings. Settings and Design: Study was done at the Department of Joint Replacement and Orthopedics, Tata Main Hospital, Interventional prospective cohort study. Subjects and Methods: Consecutive samples fulfilling study criteria were evaluated preoperatively with visual analogue scale (VAS) and preoperative functional status was assessed. The functional outcome was measured by pre- and postoperative VAS, Tegner Lysholm Knee score; X rays were used to measure pre- and postoperative “Medial joint space” and “Femoro-tibial angle (FTA).” Statistical Analysis: All the data were tabulated, and then analyzed with appropriate statistical tools “MedCalc. Chi-square test, test of significance and student paired and unpaired T-test were used. Results: There was a significant improvement in VAS score, Tegner Lysholm score postoperatively as compared to the pre-perative scores. FTA and medial joint space were also increased postoperatively. Conclusions: PFO is a good surgical alternative for medial compartmental osteoarthritis of the knee with an excellent functional outcome. A simple surgical procedure, non-requirement of specialized instruments, and low cost of surgery are some of the advantages for patients who do not want to undergo HTO or total knee replacement (TKR).

A Systematic Review of the Management of Knee Osteoarthritis by Proximal Fibular Osteotomy in the Indian Population

“…In summary, these studies collectively enhance our understanding of PFO as a potential management option for knee OA in the Indian population. Overall, we included eight studies [8][9][10][11][12][13][14][15], all prospective cohort studies and interventional studies carried out at different locations in India. In each of these studies, investigations evaluated the existing evidence concerning the management of knee OA through PFO in the Indian population.…”

“…In each of these studies, investigations evaluated the existing evidence concerning the management of knee OA through PFO in the Indian population. Across the included studies [8][9][10][11][12][13][14][15], 289 participants were included and recruited patients with medial compartment OA of the knee. All the included studies [8][9][10][11][12][13][14][15] detailed the management of knee OA through PFO.…”

“…Across the included studies [8][9][10][11][12][13][14][15], 289 participants were included and recruited patients with medial compartment OA of the knee. All the included studies [8][9][10][11][12][13][14][15] detailed the management of knee OA through PFO. Among the included studies, seven studies [8][9][10][11][12][13][14] assessed VAS score, three studies [8,9,12] assessed American Knee Society Score (AKSS), six studies assessed [8][9][10][11][12]14] FTA, one study [14] assessed KSS, and another one study [15] assessed Oxford Knee Scores (OKS).…”

“…The studies included in this systematic review exhibited variations in patient characteristics, study design, and geographic locations across different regions in India. These variations are crucial when interpreting findings and assessing the generalizability of results [8][9][10][11][12][13][14][15]. The systematic review found that studies consistently reported various clinical outcome measures, including VAS scores, KSS, OKS, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and more.…”

Jayanta k. Laik. Proximal fibular osteotomy

“…for their creditable research that that has been published in your journal. [ 1 ] Their prospective, interventional cohort study definitely adds to existing knowledge on this relatively new and cost-effective treatment method.…”