Evaluation of fibular osteotomy combining arthroscopic debridement in treatment of osteoarthritis in medial compartment of knee

Abstract

Objective To evaluate early effect of proximal fibular osteotomy combined with arthroscopic debridement in the treatment of knee osteoarthritis(OA) with medial compartment. Methods From July 2016 to July 2017, in Shaanxi Provincial People’s Hospital, 15 patients(18 knees) with medial compartment OA treated by proximal fibula osteotomy combined with arthroscopy debridement were analysed retrospectively. The inclusion criteria were pain in medial compartment of knee, X ray films showing medial compartment narrowing; the exclusion criteria were genu valgus, lateral compartment involvement and ligaments injury. Four males and 11 females with an average age of(65±13)years were enrolled.They were followed up at the 2nd day and three months after the operation.The visual analogue scale (VAS), Hospital for Special Surgery (HSS) knee score, the American Knee Society score(KSS)and the corresponding radiographic between medial and lateral compartment assessment before and after operations were evaluated. Results All 15 patients were available for a mean follow-up time of three months.The average operation duration was (50.6±15.7 )min, the average length of stay was (8.5±1.6 )d.At the final follow-up, three months after the operation mean VAS was(2.04±0.65), significantly lower than the preoperative one(F=2.91, P<0.05). Mean HSS knee score was(79.16±5.25), significantly higher than the preoperative score(56.63±6.45) (F=2.58, P<0.05). Clinical KSS knee score was(80.86±10.39), significantly higher than the mean preoperative score of (62.28±9.15) (F=3.04, P <0.05). Functional KSS knee score was(70.54±4.91), significantly higher than the mean preoperative score of (37.59±7.13) (F=2.76, P<0.05). X ray films of the weight-bearing knees were taken two days after the surgery, showing increased height of medial joint space compared with that before the operation(Z=2.091, P <0.05). Conclusion The proximal fibula osteotomy combined with arthroscopic debridement for treatment of knee osteoarthritis has the advantages of simple surgical ptoeedure, less injury and can significantly reduce the pain, which can improve the knee function and obtain excellent early curative effect. Key words: Osteoarthritis; Fibula; Osteotomy; Arthroscopes; Debridement