Evaluating the Efficacy and Long-Term Impact of Proximal Fibular Osteotomy as a Treatment Option for Knee Osteoarthritis

Abstract

Background: Knee osteoarthritis (OA) is a prevalent and debilitating musculoskeletal condition that significantly impacts the quality of life for millions of individuals worldwide. Proximal fibular osteotomy (PFO) has emerged as a promising surgical intervention aimed at alleviating pain and improving function in patients with knee OA.

Methods: The 30 cases diagnosed with medial compartment osteoarthritis knee that met the inclusion criteria were treated with proximal fibular osteotomy at the Department of Orthopaedics in a Tertiary care Hospital, after obtaining the appropriate consent and ethical committee approval. We examine various aspects of PFO, including patient selection criteria, surgical techniques, post-operative rehabilitation protocols, and key outcome measures. Additionally, we discuss the reported clinical outcomes, radiological changes, and patient-reported improvements associated with PFO.

Results: Patients in the study, range between 41 - 50 years, the majority of cases were male 17 cases (56.66 %) and the remaining were female 13 cases (43.34%), indicating a male predominance. The right Limb was involved in 18 cases (60 %) and the left limb was involved in 12 cases (40 %). Medial joint space increased in 18 cases, decreased in 3 cases, and remained unchanged in 9 cases. Varus angle decreased in all cases and became zero in 5 cases (16.66 %). The maximum correction in varus angle was 8° and the minimum correction in varus angle was 3°. VAS Score decreased in all cases and became zero in 9 cases (30 %). The maximum improvement in VAS Score was 6 and there was a worsening in pain in 1 case with an increase in VAS score by 1. Oxford's knee Score increased in all cases. The maximum increase in Oxford knee Score was 12 & minimum increase in Oxford knee Score was 1.

Conclusion: The Proximal fibular osteotomy appears to be a promising therapeutic option for knee OA, offering substantial pain relief and functional benefits. Nonetheless, further research is needed to establish standardized protocols, refine patient selection criteria, and elucidate the long-term effects of this procedure. A collaborative effort between orthopaedic surgeons and researchers is essential to optimize the utility of PFO in managing knee OA and enhance patient outcomes.