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Knee osteoarthritis is a chronic, progressive degenerative disease with accompanying joint pain, stiffness and deformity. Knee osteoarthritis is a common joint disease, with an incidence of among 30 percent of population older than 60 years. Knee Varus deformities, characterized by a mechanical femoro-tibial axis of less than 180° on full leg standing antero-posterior radiograph and narrowed medial joint space are common in patient with knee osteoarthritis and affect 74 percent of patients with idiopathic osteoarthritis. Objective: The study was intended to explore the effects of proximal fibular-osteotomy (PFO) as a new surgery for pain relief and improvement of medial joint space and function in patients with medial compartment knee osteoarthritis. Methods: The study was carried out from Sept. 2017 to Dec. 2018 in B.R.D Medical College Gorakhpur in about 52 patients of age group 45 to 75 who underwent proximal fibular-osteotomy for medial compartment osteoarthritis was prospectively followed up. Preoperative and postoperative weightbearing and whole lower extremity radiographs were obtained to analyze the alignment of the lower extremity and medial knee joint space. Knee pain was assessed using WOMAC (Western Ontario and McMaster Universities Osteoarthritis) score preoperative, post-operative and each follow up. Results: There was a female preponderance seen in our study with the right knee being most commonly affected. Post surgery, 8 patients shows good, 10 patient shows fair and 34 patient shows unsatisfactory response as evaluated by WOMAC score at follow up. Weight bearing lower extremities radiographs shows significant increase in medial knee joint space in 20 percent patients. Conclusion: From the inferences of the study we can concluded that it is simple, cost effective, and easy to perform procedure can improve both radiographic appearance and function of the affected knee joint and also achieve long term pain relief. It is associated with lesser complication and shorter recovery period as compared to High tibial osteotomy (HTO). This procedure may be an alternative treatment option for medial compartment osteoarthritis knee. A longer period of followup is necessary to evaluate whether the beneficial effects of Proximal fibular osteotomy is sustained over a period of time mainly in respect to improvement in medial joint space.

Prospective study of functional outcome of proximal fibular osteotomy in patients of knee osteoarthritis