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Research Paper | Orthopaedic Surgery | India | Volume 12 Issue 5, May 2023
Midterm Functional and Radiological Results of Proximal Fibular Osteotomy to Treat Medial Compartment Osteoarthritis: A Prospective Observational Clinical Study (2-5 Years)
Shivendra Rathore [2] | Rakesh Dhukia [2] | Mayank Ganeshani [2] | Kanti Lal Roat [2] | Narendra Joshi [2]
Abstract: Introduction: Osteoarthritis (OA) is a chronic degenerative joint disease of dynamic pathology with multifactorial aetiology. a wide variety of treatment options are available ranging from lifestyle modification, weight reduction, NSAIDs (oral and Topical), intra-articular steroids, autologous platelet rich plasma, hyaluronic acids and surgical interventions like arthroscopic joint lavage, high tibial osteotomy, and arthroplasty (partial or complete). Proximal fibular osteotomy can significantly improve both the radiographic appearance and function of the affected knee joint and achieve pain relief. We have studied mid-term (2-5 years) results of a proximal fibular osteotomy, previously operated in our institution to relieve the increasing loading force on the medial compartment for treatment of medial compartment osteoarthritis. Methodology: A Hospital based prospective observational study Department of Orthopaedics in SMS Medical College and Hospital. the Sample size was calculated to be 35 subjects. Patients were evaluated with standard anteroposterior view X-rays of both knee joints in weight bearing stance, and X-rays both knee joints lateral view to know kellgrane lawrence and ahlbach grade. Anatomical axis gives us the femorotibial angle (FTA); mechanical axis gives mechanical axis deviation. Knee rating scale for clinical evaluation of osteoarthritis is of the knee joint. Results: 1) Female predominant 54.29% were females while 45.71% were males. 2) Seventeen right knee (48.57%) and eighteen (51.42%) left knee were operated. 3) Preoperative range of motion was 0-124.06? and postoperatively range of motion was 0-126.40?. the change was statistically non-significant. 4) The mean preoperatively value of womac score was 45.06 with standard deviation. 3.89 and mean postoperatively value of womac score was 31.46 with standard deviation 9.35 and p value was<.0001. 5) The mean follow-up period was 48.58 months with standard deviation of 3.83 with maximum of 52 months and minimum of 44 months follow up duration. Conclusion: Proximal fibular osteotomy may reduce knee pain significantly in the varus osteoarthritis knee and improve the functional recovery of the knee joint. It is safe, simple and effective procedure that is an alternative to high tibial osteotomy and may delay or even negate for total knee arthroplasty for medial compartment osteoarthritis of the knee joint.
Keywords: Osteoarthritis, weight reduction, Medial opening wedge high tibial osteotomy, proximal fibular osteotomy, prospective observational study, kellgrane Lawrence, femorotibial angle
Edition: Volume 12 Issue 5, May 2023,
Pages: 2325 - 2328