Evaluation of Medial Compartment Decompression by Fibular Osteotomy to Treat Medial Compartment Knee Osteoarthritis: A Retrospective Study

Abstract

Introduction: Osteoarthritis (OA) of the knee is a debilitating old age disease causing pain and restriction in movement. Proximal Fibular Osteotomy (PFO) can be a novel surgical technique which may provide an increase in the joint space and balance the load bearing of the knee joint. The present study was conducted to determine the outcomes of this surgical technique in patients with OA of the knee. The findings may motivate many practicing orthopaedicians to undertake this surgical technique and thereby impart better quality of life to such patients. Aim: To assess the outcome in terms of medial joint space, lateral joint space, tibiofemoral angle and range of movement of medial compartment decompression by fibular osteotomy in medial compartment knee OA. Materials and Methods: This retrospective study was conducted in the Postgraduate Department of Orthopaedics, Government Medical College, Jammu, India, from November 2018 to October 2019, on 30 adult patients (both sex) aged 40-60 years who had moderate-to-severe symptomatic medial compartment knee OA. Patients who had rheumatoid arthritis, post-traumatic arthritis, congenital lower extremities defects, infections in joints, presence of ligament/meniscus injury, and those with abnormality in the lateral compartment were excluded. Preoperatively and postoperatively, medial joint space, lateral joint space, tibiofemoral angle and range of movement were assessed and compared. The p-value <0.05 was taken as statistically significant. Results: A total of 30 patients were enrolled in the study, 18(60%) were male, and 12 (40%) were female. Compared to preoperative values, postoperatively there was a significant increase in medial joint space (1.3±0.7 vs 5.2±0.9 mm, p-value<0.01), significant decrease in lateral joint space (6.9±0.3 mm vs 5.7±0.2 mm, p-value<0.01), significant decrease in tibiofemoral angle (180.7±1.02 vs. 178.13±0.97, p-value<0.01) and significant increase in range of movement (135.36±1.06 degrees vs 137.6±1.02 degrees postoperatively, p-value<0.01). The median duration of follow-up for the patients were 6 months. Conclusion: Proximal fibular osteotomy can be suitably applied in the clinical practice for OA of the knee joint and it can give prolonged beneficial outcomes for the patients.