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Year : 2021  |  Volume : 4  |  Issue : 3  |  Page : 86-91

Prospective study of functional and radiological outcome of proximal fibular osteotomy for medial compartment osteoarthritis in elderly

1 Professor of Orthopaedics, Nimra Institute of Medical Sciences, Vijayawada, Andhra Pradesh, India
2 Department of Orthopaedics, NRI Institute of Medical Sciences, Sangivalasa, Visakhapatnam, Andhra Pradesh, India

Correspondence Address:
Dr. Ravi Kiran Kakumanu
Department of Orthopaedics, NRI Institute of Medical Sciences, Sangivalasa, Visakhapatnam -531 162, Andhra Pradesh
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jodp.jodp_13_21

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Background: Osteoarthritis (OA) is the most common form of arthritis in Indian population. Proximal fibular osteotomy (PFO) is an alternative treatment to high tibial osteotomy and unicondylar arthroplasty or total knee arthroplasty. It is a surgical procedure for medial compartment knee osteoarthritis (KOA). The PFO helps in the correction of a varus deformity in KOA, which shift the loading force from the medial compartment more laterally. It, therefore, helps in decreasing the pain and satisfactory functional recovery. Objective: The objective of the study is to evaluate the clinical and radiological outcomes in medial compartment OA knee treated with minimally invasive PFO as a new and alternative modality of treatment. Materials and Methods: A total of 30 patients were selected (18 men and 12 women, age range between 50 and 72 years) from May 2019 to May 2020 who had undergone PFO for medial compartment OA knee were followed in a prospective manner. Preoperative and postoperative weight-bearing whole lower extremity scanogram was obtained to analyze the alignment of lower limb (femorotibial angle) and ratio of joint space (medial/lateral joint space). Functional outcome was assessed with American Knee Society Score (KSS), and knee pain was assessed with visual analog scale (VAS). Results: In our study, we had 30 patients who were managed by PFO and were followed up for a minimum period of 1 year. Following the surgery, all patients reported dramatic relief in pain with the VAS dropping significantly from 6.39 in the preoperative period to 2.1 postoperatively (P < 0.005). Weight-bearing lower extremities radiographs showed significant increase in medial knee joint space in 20% of patients. We also noted an increase in the medial joint space from 1.1 ± 0.29 mm preoperatively to 4.21 ± 0.7 min postoperatively. The femorotibial angle improved by around 7°, while the hip knee ankle angle improved by around 6°. Conclusion: PFO is a new alternative method in the management of medial compartment arthritis of the knee, which is minimally invasive, safe, and effective, relieves pain, and improves joint function. It helps in the correction of varus knee.

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