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The purpose of this study was to investigate the correlation between fibular head height and the incidence and severity of osteoarthritis associated with varus knee deformity. The fibular head height, joint line convergence angle (JLCA) and medial proximal tibial angle (MPTA) were measured in a three-dimensional model. Ordinal multivariate logistic regression was used to analyze the correlation between fibular head height and Kellgren–Lawrence  (K–L)  grade. Pearson correlation was used to analyze the correlation between fibular head height and  K–L  grade. A total of 232 patients (232 knees) were finally included in the study. There were significant differences in JLCA and hip–knee–ankle angle ( P  &lt; 0.05), and both JLCA and hip–knee–ankle angle increased with severe aggravation of  K–L  grade. Both fibular head height and MPTA decreased as the  K–L  grade was severely aggravated. There was a significant negative correlation between  K–L  grade and fibular head height ( r  = −0.812,  P  &lt; 0.001). Furthermore, there was a significant negative correlation between fibular head height and hip–knee–ankle angle ( r  = −0.7905,  P  &lt; 0.001). In addition to body mass index, fibular head height is a risk factor for the pathogenesis of osteoarthritis associated with varus knee deformity; the smaller the fibular head height, the more severe the degree of varus deformity.

Relationship between the height of fibular head and the incidence and severity of knee osteoarthritis