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Functional outcome of proximal fibular osteotomy in knee osteoarthritis: a prospective study

Background: Osteoarthritis of the knee joint causes debilitating pain that hampers the daily activities of affected patients. Proximal fibular osteotomy provides an option in the disease’s early stages to prolong the life of the native joint. Methods: All consenting patients with diagnosed osteoarthritis of the knee were enrolled in the study. Preoperative radiographic and clinical assessment with functional scores was conducted. Proximal fibular osteotomy was performed at a distance of 6 to 8 cm from the fibular head. Osteotomy was done and postoperative functional scores (Visual Analogue Score, Knee Society Score, Oxford Knee Score) as well as radiographic parameters (medial and lateral joint spaces and the tibio-femoral angle) were evaluated at intervals of 2 wk, 3 mo, 6 mo and 12 mo. All data were statistically analyzed. Results: Sixty patients who completed the 12-month follow-up were included. Their mean age was 62.60±9.80. The Visual Analogue Score improved from 8.65±0.75 to 2.30±0.92 at 12 mo follow-up (P<0.001), showing a significant relief in overall pain. The Knee Society Score improved from 92.6±10.63 to 144.75±17.46, showing a significant improvement (P<0.001). Improvement was seen in medial joint space and lateral joint space, but it was not statistically significant. Conclusions: Proximal fibular osteotomy is a relatively less invasive procedure compared with knee replacement and has excellent outcomes. Furthermore, it improves the overall alignment of the joint with significant relief from pain. To improve the outcome of such procedures, careful evaluation and selection of an early osteoarthritic knee joint are necessary. Level of Evidence: Level III.