Stress Effect in the Knee Joint Based on the Fibular Osteotomy Level and Varus Deformity: A Finite Element Analysis Study

Proximal fibular osteotomy (PFO) was found to relieve pain and improve knee function in patients with medial compartment knee osteoarthritis (OA). Therapy redistributes the load applied from the inside to the outside and alleviates the load applied on the inside through fibula osteotomy. Therefore, the clinical effect of fibular osteotomy using the finite element (FE) method was evaluated to calculate the exact change in stress inside a knee joint with varus deformity. Using CT and MRI images of a patient’s lower extremities, 3D models of the bone, cartilage, meniscus, and ligaments were constructed. The varus angle, representing the inward angulation of the knee, was increased by applying a force ratio in the medial and lateral directions. The results showed that performing proximal fibular osteotomy led to a significant reduction in stress in the medial direction of the meniscus and cartilage. The stress reduction in the lateral direction was relatively minor. In conclusion, the study demonstrated that proximal fibular osteotomy effectively relieves stress and redistributes the load in the knee joints of patients with medial compartment knee osteoarthritis. The findings emphasize the importance of considering force distribution and the position of fibular osteotomy to achieve optimal clinical outcomes.