Outcomes of combined proximal fibular osteotomy and arthroscopic intervention for treatment of medial compartment knee osteoarthritis

Abstract

Background This study aimed to evaluate the outcomes of combined proximal fibular osteotomy (PFO) and arthroscopic intervention for the treatment of medial compartment knee osteoarthritis. Patients and methods This prospective study included 49 knees in 44 patients (34 females and 10 males). Their mean age was 48.4 ± 5.4 years, and the mean BMI was 26.23 ± 2.44. There were 11 knees with Kellgren–Lawrence grade II, 33 with grade III, and five with grade IV. There was varus deformity (range, 6.1°–9.5°) in 34 knees. Combined PFO with arthroscopic lavage and debridement were done. Results The mean follow-up was 19.48 ± 2.45 months. There was significant improvement in the mean visual analog score (from 7.24 preoperatively to 1.7 at 12-month follow-up) and Knee Society Score (from 44.79 preoperatively to 72.95 at the final follow-up). There was significant increase in the medial knee joint space (from 1.9 preoperatively to 4.82 postoperatively). The varus angle improved significantly (from 7.8 preoperatively to 1.7 postoperatively). Till the final follow-up, there was no conversion to total knee arthroplasty. Conclusion In selected patients, PFO in combination with arthroscopic lavage and debridement could be an alternative option for treating medial compartment knee osteoarthritis through decreasing varus deformity and improving symptoms. These combined procedures could be a suitable surgical option in most developing countries that lack financial and medical resources. However, more multicentric comparative studies with long-term follow-up are required to extract more significant conclusions. Level of evidence This study was a level IV case series.