A case series of functional outcome of proximal fibular osteotomy in medial compartmental osteoarthritis of knee

Abstract

This study investigates the effectiveness of Proximal Fibular Osteotomy (PFO) as an alternative surgical intervention for managing Medial Compartmental Osteoarthritis (OA) of the knee. Over a period from October 2022 to October 2023, a prospective case series was conducted at Sri Lakshmi Narayana Institute of Medical Sciences, enrolling three patients diagnosed with confirmed Medial Compartmental OA. The inclusion criteria comprised individuals with a Kellgren–Lawrence score of 2 or higher, exhibiting varus deformity, and consenting to PFO. Patients with post-traumatic knee OA, inflammatory joint disease, or prior knee surgeries were excluded. The patient cohort, ranging in age from 42 to 54 years (mean age: 48.4 years), predominantly demonstrated right knee affliction. Follow-up assessments occurred over an average duration of 10 months post-surgery. Notably, postoperative transient extensor hallucis longus (EHL) weakness emerged in all patients, resolving within 3 to 5 weeks without any reported complications during subsequent follow-up. Outcome measures encompassed pain relief evaluation through Visual Analog Scale (VAS), functional recovery assessments using Modified Oxford scores, and radiological analysis, focusing on tibiofemoral angle and joint space measurements. Results revealed substantial pain relief, enhanced joint function, and improved joint space post-PFO, suggesting promising outcomes in managing medial knee OA. In conclusion, PFO emerged as a feasible and minimally invasive approach offering significant symptomatic relief and functional improvement in patients with medial compartmental OA. This procedure could potentially delay or obviate the necessity for more invasive surgical options like total knee arthroplasty. Careful consideration and avoidance of common peroneal nerve injury during PFO are pivotal.