A Study on the Efficacy of Proximal Fibular Osteotomy for Medial Compartment Osteoarthrosis of the Knee

Background: Medial compartment osteoarthrosis (OA) of the knee is a significant contributor to disability in the aging population. Although traditional surgical options, including high tibial osteotomy and arthroplasty, are effective, they are typically more invasive and costly. Proximal fibular osteotomy (PFO) has recently been sought as a simpler and minimally invasive treatment for pain relief and functional improvement. Aim: The aim of the study was to examine the clinical and radiological outcomes of PFO in patients with medial compartment osteoarthrosis of the knee at one-year post-operation. Methodology: In this prospective cohort study, the outcomes of 18 patients (18 knees) with medial compartment knee OA were studied. All patients underwent PFO using a consistent approach. Pain was assessed using the Visual Analogue Scale (VAS), function was examined using the American Knee Society Score (AKSS), and alignment was assessed radiologically through the medial -to- lateral (ML) joint space ratio at baseline, three months, and one year. Results: Statistically significant improvements were noted for all variables (p < 0.001). The mean VAS decreased from 7.72 ± 0.71 to 3.81 ± 1.24, clinical AKSS improved from 57.18 ± 7.14 to 72.38 ± 9.41, and functional AKSS improved from 47.92 ± 13.78 to 70.92 ± 14.87. The ML ratio also improved from 0.32 ± 0.18 to 0.50 ± 0.21. Conclusion: PFO provides substantial pain relief, improvement of function, and biomechanical realignment making it a safe, cost effective, and minimally invasive option to treat medial compartment knee OA.