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Proximal Fibular Osteotomy–A Novel Technique for Decompression of Isolated Medial Compartment Osteoarthritis Knee


Affiliations
1 P.G. Resident M/S Orthopaedics, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, India
2 HOD Department Orthopaedics, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, India
3 Professor Department Orthopaedics, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, India
4 Associate Professor, Deptt. Anatomy, Government Medical College and Hospital, Patiala, India
     

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Introduction: Proximal Fibular Osteotomy (PFO) is removing 1-1.5 cm of FIBULA, 7 to 10 cm below its head, which provides symptomatic relief from pain of medial compartment Osteoarthritis (OA) knee. It is a procedure wherein we remove Proximal part of fibula to stop mechanical axis of knee going into further varus and hence putting a stop to progression of disease. The aim of the study was to observe and study the resultsin patients of isolated medial compartment Osteoarthritis of Knee,treated by Proximal Fibular Osteotomy. Material and Method: The study was conducted on 36 patients amounting to 50 knee joints (male and female between the age of 50-70 years) with medial compartment OA Knee. Patients were followed up till 6 months. Medial and lateral joint space along-with visual analogue score for pain were recorded preoperative, immediate post-operative and at final follow up. Result: Significant improvement in mean visual analogue pain score (VAS), from 7.32 + 0.98 preoperative to 2.72 + 1.20 at the final follow up was observed (p-value <0.001). Medial joint space opening from 1.17 + 0.29 to 4.07 + 0.69 at final follow up was observed. American knee society score was divided into 2 subsets, knee score and functional score. Both of them showed significant improvements from 39.72 + 3.47 and 44.20 + 8.47 (pre-operative) to 86.58 + 10.79 and 84.60 + 8.38 respectively, at final follow up (p-value < 0.001). Conclusion: The objective as well as functional outcome after proximal fibular osteotomy were satisfactory. With correct patient selection and meticulous adherence to basics, Proximal fibular osteotomy offers an excellent alternative to tedious and extensive procedures like High tibial osteotomy (HTO) and Unicompartmental Knee Arthroplasty (UKA). It is specially enthralling in country like ours where everyone cannot afford expensive surgeries and are forced to live a life of misery and morbidity.

Keywords

Medial compartment Osteoarthritis Knee, PFO, American Knee Society Score, Fibular osteotomy.
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  • Proximal Fibular Osteotomy–A Novel Technique for Decompression of Isolated Medial Compartment Osteoarthritis Knee

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Authors

Vishesh Verma
P.G. Resident M/S Orthopaedics, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, India
Manjeet Singh
HOD Department Orthopaedics, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, India
Ashwani Ummat
Professor Department Orthopaedics, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, India
Praveen Thivari
P.G. Resident M/S Orthopaedics, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, India
Harsimarjit Kaur
Associate Professor, Deptt. Anatomy, Government Medical College and Hospital, Patiala, India
Jasneet Chawla
P.G. Resident M/S Orthopaedics, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, India
Vineet Pruthi
P.G. Resident M/S Orthopaedics, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, India

Abstract


Introduction: Proximal Fibular Osteotomy (PFO) is removing 1-1.5 cm of FIBULA, 7 to 10 cm below its head, which provides symptomatic relief from pain of medial compartment Osteoarthritis (OA) knee. It is a procedure wherein we remove Proximal part of fibula to stop mechanical axis of knee going into further varus and hence putting a stop to progression of disease. The aim of the study was to observe and study the resultsin patients of isolated medial compartment Osteoarthritis of Knee,treated by Proximal Fibular Osteotomy. Material and Method: The study was conducted on 36 patients amounting to 50 knee joints (male and female between the age of 50-70 years) with medial compartment OA Knee. Patients were followed up till 6 months. Medial and lateral joint space along-with visual analogue score for pain were recorded preoperative, immediate post-operative and at final follow up. Result: Significant improvement in mean visual analogue pain score (VAS), from 7.32 + 0.98 preoperative to 2.72 + 1.20 at the final follow up was observed (p-value <0.001). Medial joint space opening from 1.17 + 0.29 to 4.07 + 0.69 at final follow up was observed. American knee society score was divided into 2 subsets, knee score and functional score. Both of them showed significant improvements from 39.72 + 3.47 and 44.20 + 8.47 (pre-operative) to 86.58 + 10.79 and 84.60 + 8.38 respectively, at final follow up (p-value < 0.001). Conclusion: The objective as well as functional outcome after proximal fibular osteotomy were satisfactory. With correct patient selection and meticulous adherence to basics, Proximal fibular osteotomy offers an excellent alternative to tedious and extensive procedures like High tibial osteotomy (HTO) and Unicompartmental Knee Arthroplasty (UKA). It is specially enthralling in country like ours where everyone cannot afford expensive surgeries and are forced to live a life of misery and morbidity.

Keywords


Medial compartment Osteoarthritis Knee, PFO, American Knee Society Score, Fibular osteotomy.



DOI: https://doi.org/10.37506/v11%2Fi2%2F2020%2Fijphrd%2F194926