Rakesh Kumar Misra and Ashish Vinodkumar Batra
Background: In Low and Middle Income Countries (LMIC), there is an alternative surgical procedure of Proximal Fibular Osteotomy (PFO) has developed for osteoarthritis of knee joint. It is simple, safe and affordable. PFO helps relief pain in almost all patients.
Methodology: We retrospectively analysed 38 patients who underwent PFO in our hospital during the period from August to October 2018. Inclusion criteria are patient with moderate to severe symptoms of the knee with grade 2 knee OA on radiographs. Clinical data, Visual Analogue Scale score (VAS score) and American Knee Society Score (AKSS score) were recorded. Patients were followed up at 6 weeks, 12 weeks, and 6 months postoperatively.
Results: 38 patients (38 knees) were included in this study out of which 6 knees (L=2, R=4) were of males and 32 knees (L=11, R=21) were of females. The mean age was 52.4 years. The average preoperative VAS score, KSS clinical and functional score was 7.89 ± 1.01 points (range from 4 to 9 points), 47.23 ± 11.05 points (range from 26 to 90 points) and 45.85 ± 16.62 points (range from 0 to 90 points), respectively. At 6 months, the mean visual analogue scale scores significantly decreased to 2.74-2.34 postoperatively. There was significant improvement in the average postoperative KSS clinical and functional scores which is 67.11 ± 10.09 points (range from 31 to 94 points) and 65.67 ± 12.22 points (range from 22 to 100 points), respectively. The ratio of the knee joint space (medial/lateral compartment) increased from an average of 0.38 ± 0.12 preoperatively to 0.56 ± 0.13 postoperatively.
Conclusion: The PFO is a promising surgical option in countries that lack financial and medical resources.