Early Clinical Effect And Radiographic Evaluation Of Proximal Fibula Osteotomy In The Treatment Of Early And Middle Knee Osteoarthritis

Objective:To evaluate early clinical effect of proximal fibula osteotomy in the treatment of early and middle knee osteoarthritis(OA).Methods:25 patients(27 knees)with KOA received proximal fibular osteotomy in Affiliated DAYI Hospital of Shanxi Medical University from February 2015 to April 2016,data were collected retrospectively.The visual analogue scale(VAS),the American knee society score(KSS),the Lysholm Knee Scale,the femorotibial angle(FTA),the tibial plateau-tibial shaft angle(TP-TSA),the hip-knee-ankle angle(HKA),the distance of the lateral knee joint space and the distance between fibula lateral tubercle and lateral tibial plateau were evaluated at 3 days,3 months,6 months,1 year after surgery.Results:25 cases(27 knees)accepted 1 year follow-up visit.The average operation duration was(64±27.5)min,the mean operative blood loss was(16±9.5)ml and average length of postoperative hospital stay was(4±1.2)d.The differences of VAS,KSS knee clinical score,KSS functional score and Lysholm Knee Scale between preoperation and 1 day,3months,6 months,1 year post-operation were statistically significant(F=94.446,P<0.05;F=69.820,P<0.05;F=58.363,P<0.05;F=51.410,P<0.05).At the final follow-up,the TP-TSA increased from(84.3±2.3)°to(85.0±2.4)°,the lateral knee joint space height decreased from preoperative(0.731±0.104)cm to(0.665±0.960)cm,the distance between fibula lateral tubercle and lateral tibial plateau increased from(3.370±0.411)cm to(3.495±0.397)cm,differences were statistically significant(P<0.05).X-ray films of total limb length were taken before and after surgery in 14 cases,the HKA increased from(173.9±4.3)° to(176.0±3.2)°,differences were statistically significant(P<0.05).There was no statistical difference about FTA between preoperation and post-operation(t=1.204,P>0.05).Conclusions:The proximal fibular osteotomy showed excellent early effect in the treatment of early and middle knee osteoarthritis.It significant relieve pain,improve the knee function and life quality of KOA patients.