Functional and Radiological Outcomes between Proximal Fibular Osteotomy Versus Medial Open Wedge High Tibial Osteotomy for Management of Medial Compartment Knee Osteoarthritis

Background: Osteoarthritis is one of the most common causes of disability in the eldery population. Disability is caused by pain and limited mobility.

Objectives: This work aims to compare the functional and radiological results of proximal fibular osteotomy in medial compartment osteoarthritis, with medial opening wedge high tibial osteotomy.

Methods: This prospective randomized clinical trial was done on 32 patients suffering from manifestation of medial compartment osteoarthritis of the knee joint. Patients were distributed into two groups: The control group; 16 patients representing the HTO technique and the Case group; 16 patients representing the PFO. The follow-up period was approximately 12 months after the operation. Operation time, clinical, and radiological results, and complications were compared between the two groups.

Results: the operative duration was significantly longer among patients treated by HTO compared to patients treated by PFO (37.2± 4.8 minutes vs. 25.9± 6.4 minutes). The mean preoperative KSS score was 65.3± 3.5 and 67.2± 5.4 among PFO and HTO respectively. KSS scores at 3 months and 9 months were significantly higher among PFO than HTO. VAS, KSS, and radiological assessment were significantly improved postoperative among PFO and HTO.

Conclusion: Proximal fibular osteotomy might be a safe alternative treatment to high tibial osteotomy with better functional and radiological outcomes.