Proximal fibular osteotomy for pain relief and functional improvement in patients of osteoarthritis of knee

Kumar, Anil; Saurabh, Anand; Shekhar, Shubhanshu; Kunwar, Abhijeet; Verma, Vishal

doi:10.18203/2349-2902.isj20192957

Cited by 14 publications

(29 citation statements)

References 7 publications

(8 reference statements)

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“…The results of their study suggest that the benefits of PFO may not be long-lasting. This is in contrast with the improved radiological outcome reported in the present study and several other published studies [7,9,[12][13][14][15]. A retrospective study by Yang et al has shown that the improvement in radiological outcome continues beyond one year [15].…”

Section: Discussioncontrasting

confidence: 99%

“…The AKSS grades the outcome as poor (<60), fair (60-69), good (70-79), and excellent (>80) [18]. An excellent outcome in functional subsets of the AKSS (72.06 ±7.30 and 87.90 ±7.08) has been reported in another study [9]. However, that study involved patients who had comparatively higher preoperative clinical and functional scores (62.13 ±11.90 and 55.16 ±4.15) compared to our study (56.49 ±6.95 and 48.24 ±14.31) and that might be the reason for the higher postoperative scores.…”

Section: Discussionmentioning

confidence: 66%

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Proximal Fibular Osteotomy for Medial Joint Osteoarthritis of the Knee: A Prospective Cohort Study

Kumar¹,

Srivastava²,

Kumar³

et al. 2021

Cureus

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Background and objective Osteoarthritis (OA) is a polyarticular disease that most commonly afflicts the knee joint. Established operative treatment options for medial joint OA of the knee include high tibial osteotomy, unicompartmental knee arthroplasty, and total knee arthroplasty. Proximal fibular osteotomy (PFO) is a relatively new procedure for treating medial joint OA of the knee. The objective of this study was to describe the functional and radiological outcomes at one year in patients undergoing PFO for medial joint OA of the knee. Materials and methods The study included 21 patients with medial joint OA of the knee who underwent PFO. Visual analog scale (VAS) score, medial to lateral knee joint space ratio (ML ratio), Kellgren-Lawrence (KL) grade, and the American Knee Society Score (AKSS) (clinical and functional) were recorded preoperatively. VAS score, ML ratio, and AKSS (clinical and functional) were documented again at the three-month and one-year follow-ups. Results The mean age of the patients was 58.85 ±6.94 years; 12 (57.1%) were female and nine (42.9%) were males. The mean VAS score for pain decreased from 7.86 ±0.66 at baseline to 5.14 ±1.15 at three months (p<0.001) and 3.78 ±1.26 at one year (p<0.001). The mean clinical AKSS was 56.49 ±6.95 at baseline, which increased to 63.41 ±6.20 at three months (p<0.001) and 72.71 ±9.87 at one year (p<0.001). The mean functional AKSS at baseline was 48.24 ±14.31, which increased to 60.10 ±14.81 at three months (p<0.001) and 71.46 ±15.18 at one year (p<0.001). The mean ML ratio at baseline was 0.33 ±0.19, which increased to 0.41 ±0.20 at three months (p<0.01) and 0.51 ±0.22 at one year (p<0.001). Conclusion In patients who undergo PFO for OA of the knee, improvements in VAS score for pain, AKSS (functional and clinical), and ML ratio were observed to be maintained for a period of one year postoperatively.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 66%

Proximal Fibular Osteotomy for Medial Joint Osteoarthritis of the Knee: A Prospective Cohort Study

Kumar¹,

Srivastava²,

Kumar³

et al. 2021

Cureus

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“…The incidence of knee OA increases with age and increases with longevity and higher mortality. [7][8][9] In the current study, the mean age of the patients was found to be 58.9 years. Fifty percent of patients were in the age groups of 56 to 65 years.…”

Section: Discussionmentioning

confidence: 79%

To Study the Functional Outcomes of Proximal Fibular Osteotomy in Osteoarthritis Kee

Verma¹,

Agrawal²

2020

IJCMR

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Introduction: Knee osteoarthritis (OA), also known as degenerative joint disease, is typically the result of wear and tear and progressive loss of articular cartilage leading to radiologically decreased joint space. Proximal fibular osteotomy (PFO) is an alternative treatment to high tibial osteotomy (HTO). Hence; under the light of above mentioned data, the present study was undertaken for assessing the functional outcomes of proximal fibular osteotomy in osteoarthritis knee. Material and methods:A total of 10 patients with OA of knee were enrolled in the present study. The patients were placed in the supine position after administration of spinal anaesthesia. An approximately 5-cm longitudinal incision was made over the lateral aspect of the proximal fibula, and the fibula exposed between the peroneus muscle and soleus muscle. PFO was performed under the hands of skilled and experienced orthopaedic surgeon. Knee pain was assessed using a Visual analogue scale. Knee ambulation activities were recorded using the knee and function subscores of the American Knee Society score (KSS). All the results were recorded in Microsoft excel sheet and were analyzed by SPSS software. Chi-square test and Mann Whitney U test were used for assessment of level of significance. Results:Mean KSS score at pre-operative, postoperative, postoperative 6 weeks and postoperative 9 months were found to be 44.03, 53.50, 58.60 and 68.14 respectively. Significant results were obtained while comparing the mean KSS at different postoperative time intervals. In the present study, mean VAS score at pre-operative, postoperative, postoperative 6 weeks and postoperative 9 months were found to be 8.77, 6.96, 4.36 and 2.52 respectively. Significant results were obtained while comparing the mean VAS at different postoperative time intervals.Conclusion: PFO is a novel alternative method in the management of medial compartment arthritis of the knee.

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“…Additionally, obvious change in alignment was observed in the whole lower extremity radiographs in 24 out of 30 patients. In three patients tibio-femoral angle showed progressive more varus alignment after proximal fibulectomy [18] . PFO has emerged as a new surgery to relieve pain and improve joint function in patients with knee osteoarthritis.…”

Section: Discussionmentioning

confidence: 87%

“…walking) was also obviously improved when compared with the preoperative state. PFO also improved the axial alignment of the lower extremity in some patients, especially in those with severe genu varus [17,18] .…”

Section: Discussionmentioning

confidence: 89%

To evaluate the functional outcomes of proximal fibular osteotomy in osteoarthritis knee: A study of 30 cases

Sandhu¹,

Kahal²,

Sareen³

et al. 2020

Int. J. Orthop. Sci.

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Background: Osteoarthritis (OA) is the most common form of arthritis in the world. Proximal fibular osteotomy (PFO) is an alternative treatment to high tibial osteotomy (HTO). It is a surgical procedure for medial compartment knee osteoarthritis (KOA). Hence; the present study was undertaken for assessing the functional outcomes of proximal fibular osteotomy in osteoarthritis knee. Materials & Methods: A total of 30 patients were assessed. The patients were placed in the supine position after administration of spinal anaesthesia. An approximately 5-cm longitudinal incision was made over the lateral aspect of the proximal fibula, and the fibula exposed between the peroneus muscle and soleus muscle. Knee pain was assessed using a Visual analogue scale. Medical joint space and the hip knee-ankle angle was measured. based on the whole lower extremity radiograph. Results: Significant improvement was observed in the mean VAS improved from preoperative value of 8.23 to 2.1 at 9 months postoperative follow-up. Significant improvement was observed in the Mean knee joint space from preoperative value of 0.35 to 0.58 at 9 months postoperative follow-up. Significant improvement was observed in the mean hip knee ankle angle from preoperative value of 184.2 to 177.3 at 9 months postoperative follow-up. Conclusion: PFO is a novel alternative method in the management of medial compartment arthritis of the knee.

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Proximal fibular osteotomy for pain relief and functional improvement in patients of osteoarthritis of knee

Cited by 14 publications

References 7 publications

Proximal Fibular Osteotomy for Medial Joint Osteoarthritis of the Knee: A Prospective Cohort Study

Proximal Fibular Osteotomy for Medial Joint Osteoarthritis of the Knee: A Prospective Cohort Study

To Study the Functional Outcomes of Proximal Fibular Osteotomy in Osteoarthritis Kee

To evaluate the functional outcomes of proximal fibular osteotomy in osteoarthritis knee: A study of 30 cases

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