Proximal Fibular Osteotomy for Medial Joint Osteoarthritis of the Knee: A Prospective Cohort Study

Background and objective Osteoarthritis (OA) is a polyarticular disease that most commonly afflicts the knee joint. Established operative treatment options for medial joint OA of the knee include high tibial osteotomy, unicompartmental knee arthroplasty, and total knee arthroplasty. Proximal fibular osteotomy (PFO) is a relatively new procedure for treating medial joint OA of the knee. The objective of this study was to describe the functional and radiological outcomes at one year in patients undergoing PFO for medial joint OA of the knee. Materials and methods The study included 21 patients with medial joint OA of the knee who underwent PFO. Visual analog scale (VAS) score, medial to lateral knee joint space ratio (ML ratio), Kellgren-Lawrence (KL) grade, and the American Knee Society Score (AKSS) (clinical and functional) were recorded preoperatively. VAS score, ML ratio, and AKSS (clinical and functional) were documented again at the three-month and one-year follow-ups. Results The mean age of the patients was 58.85 ±6.94 years; 12 (57.1%) were female and nine (42.9%) were males. The mean VAS score for pain decreased from 7.86 ±0.66 at baseline to 5.14 ±1.15 at three months (p<0.001) and 3.78 ±1.26 at one year (p<0.001). The mean clinical AKSS was 56.49 ±6.95 at baseline, which increased to 63.41 ±6.20 at three months (p<0.001) and 72.71 ±9.87 at one year (p<0.001). The mean functional AKSS at baseline was 48.24 ±14.31, which increased to 60.10 ±14.81 at three months (p<0.001) and 71.46 ±15.18 at one year (p<0.001). The mean ML ratio at baseline was 0.33 ±0.19, which increased to 0.41 ±0.20 at three months (p<0.01) and 0.51 ±0.22 at one year (p<0.001). Conclusion In patients who undergo PFO for OA of the knee, improvements in VAS score for pain, AKSS (functional and clinical), and ML ratio were observed to be maintained for a period of one year postoperatively.