Proximal fibular osteotomy in the treatment of medial osteoarthritis of the knee – A narrative review of literature

Shanmugasundaram, Saseendar; Kambhampati, Srinivas B. S.; Saseendar, S.

doi:10.1186/s43019-019-0016-0

Cited by 25 publications

(28 citation statements)

References 33 publications

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“…PFO hypothetically works on the principle of redistribution of forces towards the lateral compartment as described by Wang et al ., Yang et al ., and Shanmugasundaram et al . [ 19 20 22 ]…”

Section: Discussionmentioning

confidence: 99%

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

Laik

Kaushal

Kumar

et al. 2020

J Family Med Prim Care

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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).

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“…PFO hypothetically works on the principle of redistribution of forces towards the lateral compartment as described by Wang et al ., Yang et al ., and Shanmugasundaram et al . [ 19 20 22 ]…”

Section: Discussionmentioning

confidence: 99%

“…PFO works in the principle of diverting the mechanical axis to the lateral compartment, which is not affected by the arthritic process, leading to relief of symptoms. [ 19 20 22 ]…”

Section: Introductionmentioning

confidence: 99%

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

Laik

Kaushal

Kumar

et al. 2020

J Family Med Prim Care

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“…Various systems Osteoarthritis (OA) of the knee joint is a chronic, degenerative disease associated with pain, decreased range of motion, and deformity in the affected joint [1] . Age over 65 years of female sex, with obesity, hypertension and low frequency of strength exercises were risk factors [2] . The reported prevalence of radiographic and symptomatic OA of the knee in elderly persons above 60 years age is estimated to be 37% and 12%, respectively [3] .…”

Section: Introductionmentioning

confidence: 99%

Clinical and functional outcome of proximal fibular osteotomy for management of medial compartment osteoarthritis of the knee

Desai¹,

Gupta²,

Parmar³

et al. 2021

Int. J. Orthop. Sci.

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Osteoarthritis (OA) of the knee joint is a chronic, degenerative disease associated with pain, decreased range of motion, and deformity in the affected joint. Proximal fibular osteotomy (PFO) works on the principal that by removing proximal part of Fibula, medial and lateral compartment of the knee are evenly loaded on weight bearing and hence the medial joint pain and Arthritic changes resolve. This study was undertaken to study outcomes of Proximal fibular osteotomy (PFO) in the Population of South Gujarat attending our hospitals with medial compartment Osteoarthritis of The knee. Materials and Methodology: This is a prospective study of patients who attended the orthopedic out pateint Department in our hospital between September 2018 to November 2019. .In our orthopedics department 42 patient operated for medial compartment Osteoarthritis of the knee with proximal fibular osteotomy. In the follow up Period 5 patient lost follow up in the covid 19 pandemic and 2 patient expired Due to covid 19. So that this patient excluded from the study. Results: In our study, in terms of improvement, two significant differences were found in terms of pain relief, the mean VAS before surgery was 8.00 ± 0.79, which Improved to 2.25 ± 0.792; that was significant in terms of patient relief of pain. Similarly, in terms of comparison of function, the mean preoperative knee Clinical score was 42.75 postoperatively it improved to 83.25 and mean knee Functional score preoperative was 72.5 and postoperatively was 94.37. All These findings, i.e., VAS, and knee score and functional score, were all Suggestive of the beneficial effects of PFO in terms of pain relief and function. Mean HKA angel pre-operative was 173 and postoperatively 173.87 Suggested minimal alignment of mechanical axis. Conclusions: Proximal fibular osteotomy is a simple, safe, less time consuming, and Effective procedure for pain relief and functional recovery. It requires little Rehabilitation and is associated with little or no complications. After a review of the results of our study it was revealed that this procedure is reasonably good both clinically and radiologically, and can be recommended for Medial compartment OA of the knee joint

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“…That said, the mechanisms proposed are multiple, also implying that the procedure and its mechanisms are still being understood. [ 2 ]…”

mentioning

confidence: 99%

“…Hence a posterolateral approach between the peroneus longus and brevis muscle is advisable instead of a direct lateral approach. [ 2 3 5 ]…”

mentioning

confidence: 99%

Jayanta k. Laik. Proximal fibular osteotomy

Alfaro

Gopal²

2021

Journal of Family Medicine and Primary Care

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Proximal fibular osteotomy in the treatment of medial osteoarthritis of the knee – A narrative review of literature

Cited by 25 publications

References 33 publications

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

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

Clinical and functional outcome of proximal fibular osteotomy for management of medial compartment osteoarthritis of the knee

Jayanta k. Laik. Proximal fibular osteotomy

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