Knee Salvation Procedure (Arthroscopic Debridement Combined with LP-PRP Intraarticular Injection and Proximal Fibular Osteotomy) vs Proximal Fibular Osteotomy Alone in the Management of Medial Compartment Knee Osteoarthritis: A Comparative Study of 60 Cases

Abstract

Objective: The study was performed to compare the outcomes of Knee salvation procedure (KSP) and Proximal Fibular Osteotomy (PFO) in medial compartment osteoarthritis (OA) of knee joint. Knee salvation procedure includes Arthroscopic lavage and debridement combined with Leucocyte poor platelet rich plasma [LPPRP] application and Proximal fibular osteotomy. Material and Methods: 60 patients with medial compartment osteoarthritis of knee joint were selected prospectively and randomly allocated into knee salvation procedure (KSP) group( 30 patients, observation group ) and PFO group ( 30 patients, control group ). The follow up period was 1 year and outcomes were compared between the two groups. Results: VAS score improved in patients postoperatively and was settled to lower values by the end of 1 year of follow up (P < 0.005). The mean Knee score rating of patients Pre operatively was 53.1 ± 6 and 75.4 ± 10.16 at the end of 1 year postoperative follow up. The mean function score pre operatively was 46.5 ± 13.84 which improved to 71.50 at the end of 1 year. The majority of patients who were with normal Body mass index had good to excellent results. The mean ratio MJS/LJS Post operatively improved for KSP and PFO group (P- value <0.0001) Conclusion: In medium to long term KSP has superior effects than PFO in improving the VAS score and KSS while PFO has better effects in immediate postoperative to short term. BMI also has implication in outcome of procedures with better results in normal BMI patients in KSP group. Keywords: osteoarthritis (OA), Proximal Fibular Osteotomy (PFO), LP-PRP, Knee Salvation Procedure, Visual Analogue Scale (VAS), Medial Joint Space (MJS), Lateral Joint Space (LJS), Knee Society Score (KSS), Body mass index (BMI).