Changes in ankle joint alignment after proximal fibular osteotomy

Abstract

The purpose of this study was to assess the effect of proximal fibular osteotomy (PFO) on ankle joint. 49 patients or 53 lower limbs were included and followed-up with a minimum of one year in the study prospectively. Patients were evaluated radiographically and clinically. The questionnaires of the American Knee Society Score (KSS), the Ankle-Hindfoot Scale of the American Orthopedic Foot and Ankle Society (AOFAS), Visual Analogue Scale/Score (VAS) were used to assess the patients clinically. Radiographic evaluations were measured by the hip-knee-ankle angle (HKA), the femoro-tibial angle (FTA), tibial inclination (TI), distal tibial articural surface (TAS), talar tilt (TT), length of fibular (FL), and hind foot alignment such as hindfoot alignment view angle (HAVA), hindfoot alignment ratio (HAR), and hindfoot moment arm (HMA). Of the 53 subjects, no significant differences were exhibited in AOFAS, VAS scores and FL in ankle joint, but a significant differences were demonstrated in KSS score, HKA, FTA, TI, TT, HAVA, HAR and HMA after PFO. Due to the structural improvements of ankle joint, PFO not only improves joint function but also the alignment of ankle joint radiographically, and is still recommended as a safe surgery in treating medial compartment osteoarthritis of knee.

Effects of proximal fibular osteotomy on stress changes in mild knee osteoarthritis with varus deformity: a finite element analysis

“…However, PFO also presents some limitations in correcting the alignment of the lower limb. A clinical study has reported that PFO is merely suitable for patients with mild varus deformity of the knee (≤ 5°) and has recommended applications of restorable spacers and four-point support plates to correcting alignment of lower limb in terms of severe varus deformity (≥ 5°) [25]. In our study, the average knee varus angle in KOA patients was 7.17 ± 1.32°, and post-PFO values of the maximal von Mises stress of femoral cartilage, medial meniscus, medial tibial cartilage, and tibial plateau in all patients were significantly lower than those before the surgery.…”

Anatomical Basis of the Support of Fibula to Tibial Plateau and Its Clinical Significance

“…It might be the anatomical and pathological mechanism of nonuniform settlement. It was indirectly indicated that the forces of the tibia were uneven in medial and lateral [17][18][19][20]. There was evidence that the progression of KOA was related to the tibiofemoral articular stress distribution [21].…”

Effect of biomechanical correction of tibia on medial joint space loading, varus deformity and functional tasks in patients with medial tibiofemoral joint osteoarthritis: a two-group pre-test, post-test randomized clinical trial study protocol

“…O objetivo do presente estudo é verificar se a correção biomecânica pode corrigir o desalinhamento do osso da tíbia e se a deformidade em varo pode melhorar as atividades funcionais dos pacientes com osteoartrite. Existem vários procedimentos de tratamento que foram utilizados para reduzir a pressão no estreitamento do espaço articular medial 16 , como artroplastia parcial e total do joelho 17 , osteotomia dos fibulares 18 , modificação do calçado 19 , tratamento da palmilha em cunha lateral 20 e terapia manual são procedimentos terapêuticos muito eficazes. 21 Até onde sabemos, não há um único estudo realizado sobre a correção do desalinhamento biomecânico das articulações tibiofemorais mediais sem qualquer intervenção cirúrgica.…”