Short-term Outcome Analysis of Proximal Fibular Osteotomy in Management of Osteoarthritis Knee

Abstract

Aim: Proximal fibular osteotomy (PFO) for osteoarthritis (OA) knee is an emerging concept with good early results. This short-term study aimed to analyze the usefulness of PFO in Indian patients with OA knee with regard to pain relief and correction of deformity. Materials and methods: This study involves a surgical technique where 2 cm of proximal fibular bone is resected, and patient is permitted fullweight-bearing walking as early as possible. Subjective and objective outcome analyses done using Lysholm knee scoring sheet and radiographs, respectively. Minimum follow-up time was 6 months. Results: We had a of total of 20 knees in 18 patients, with average age of 56.1 years. The average visual analog score reduced by 6.8 points, and the average Lysholm knee score improved by an average of 34 points at the end of follow-up. The mean alpha angle correction achieved was 3.738°. The calculation of Pearson's correlation coefficient between the amount of correction of alpha angle and reduction of visual analog scale during the immediate postoperative period was −0.186. Among the 20 knees, we had four cases of weakness of extensor hallucis longus. Conclusion: Through our short-term prospective cohort study, we conclude that PFO helps in improvement of pain and function, in patients suffering from medial compartment OA knee. The effectiveness of proximal tibiofibular joint mechanism in immediate pain relief is evident in our study by subjective and objective means. A proper selection of case with regard to severity and duration of disease and patellofemoral involvement is vital in getting good results. Clinical significance: Proximal fibular osteotomy is an emerging concept in the management of OA of knee and gives the patient, more years, with native knee to walk.

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.…”

“…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. These measures allowed for assessing pain relief, functional improvement, and quality of life after PFO [8][9][10][11][12][13][14][15].…”