PROXIMAL FIBULAR OSTEOTOMY VERSUS MEDIAL OPENING WEDGE HIGH TIBIAL OSTEOTOMY TO TREAT MEDIAL COMPARTMENT KNEE OSTEOARTHRITIS: A RANDOMIZED CLINICAL TRIAL

Khalil, Tarek Mohammed; Nassar, Wael Ahmed Mohammed; Sakr, Hossam Moussa; Zakaria, Zeiad Mohammed; El Seddawy, Ashraf Mohammed; Morsy, Ahmed Mamdouh Mokhtar

doi:10.21608/asmj.2021.167384

PROXIMAL FIBULAR OSTEOTOMY VERSUS MEDIAL OPENING WEDGE HIGH TIBIAL OSTEOTOMY TO TREAT MEDIAL COMPARTMENT KNEE OSTEOARTHRITIS: A RANDOMIZED CLINICAL TRIAL

Document Type : Original Article

Authors

¹ Orthopedic Surgery, Faculty of Medicine, Ain Shams University, Egypt.

² Diagnostic Radiology Department, Faculty of Medicine, Ain Shams University, Egypt.

³ Saudi German Hospital, Cairo, Egypt.

10.21608/asmj.2021.167384

Abstract

Background: Osteoarthritis is the most common cause of disability in the older population. Disability is caused by pain and limitations in mobility. Total knee arthroplasty, which aims to relieve pain and improve joint function and mobility, is the main surgical alternative in this patient population.
Aim of the work: The aim of this work is to compare the functional and radiological outcomes of proximal fibular osteotomy in medial compartment decompression, with medial opening wedge high tibial osteotomy.
Patients and Methods: This prospective randomized clinical trial was done between March 2017 and May 2019 on 40 patients suffering from manifestation of medial compartment osteoarthritis of the knee joint. Patients were allocated into two groups: Control group; 20 patients representing the standard HTO technique and Case group; 20 patients representing the novel technique PFO.
Results: In our study we compared the outcome of 40 patient complaining of medial knee OA according to VAS, KSS and radiological assessment of joint space, we found improvement in outcome of HTO than PFO. However, PFO may be a promising alternative in most developing countries because of their financial and healthcare delivery limitations. Furthermore, these patients can still undergo TKA in the future if it becomes necessary, PFO may be considered in patients with mild medial compartment osteoarthritis over HTO.
Conclusion: Our preliminary data clearly demonstrate that PFO is a simple, fast and affordable surgery to relieve pain and improve joint function and the medial joint space in human knee osteoarthritis. However, in this study we only assessed the short term follow up, so further studies are needed to assess the long-term outcome.

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