Short term effect of proximal fibular osteotomy in treatment of medial compartment knee osteoarthritis

doi:10.3877/cma.j.issn.1674-134X.2020.06.004

Abstract

Abstract:

Objective

To observe and analyze the short-term effects of proximal fibular osteotomy and total knee arthroplasty in the treatment of medial compartment knee osteoarthritis.

Methods

The patients who received proximal fibular osteotomy (PFO) and total knee arthroplasty (TKA) in the orthopedics department of Chifeng Baoshan Traditional Chinese Medicine Hospital from January 2018 to December 2019 were reviewed. The patients with diagnosis of medial compartment knee osteoarthritis and Kellgren-Lawrence grade III and IV and with complete follow-up data were included. The knee intraarticular deformity and other diseases affecting joint function were excluded, and serious medical diseases and valgus deformity were excluded. 55 patients received PFO were included in the observation group and 55 patients received TKA were included in the control group. The operation time, incision length, intraoperative blood loss, length of hospital stay and hospitalization expenses of the two groups were compared by t test. Visual analogue scale (VAS)score, Hospital for special surgery(HSS) score, the Western Ontario and McMaster Universities osteoarthritis index (WOMAC) score, short form 36 questionnaire (SF-36) score before and three months after operation were statistically analyzed, and t test was used for intra group and inter group comparison.

Results

The operation time, incision length, intraoperative blood loss, length of stay and hospitalization expenses in the observation group were significantly lower than those in the control group (t= 8.712, 9.251, 9.435, 8.987, 9.296, all P<0.01). The VAS, HSS, WOMAC, SF-36 scores of the two groups were significantly improvedafter operation(observation group: t=7.692, 7.802, 8.453, 7 622, all P<0.01; control group: t=7.639, 7.787, 8.441, 7.619, all P<0.01), and there was no significant difference between the two groups (t=0.258, 0.401, 0.250, 0.542, all P>0.05).

Conclusions

Good clinicalresults can be achieved in the early treatment of medial compartment knee arthritis by proximal fibular osteotomy and total knee arthroplasty. Because of simple, minimally invasive and low cost, PFO can be used selectively in clinic.

Key words: Osteoarthritis, knee, Fibula, Osteotomy, Knee prosthesis

Ao Yang, Xiaowei Meng, Zhiqiang Li. Short term effect of proximal fibular osteotomy in treatment of medial compartment knee osteoarthritis[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2020, 14(06): 670-674.

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References 20

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组别	例数	年龄[岁，(±s)]	性别(男/女)	BMI [kg/m²，(±s)]	膝内翻角[°，(±s)]	K-L分型(Ⅲ/Ⅳ)
观察组	55	66.5±7.8	25/30	23.7±4.1	9.5±2.1	25/30
对照组	55	66.8±8.0	24/31	23.9±4.2	9.7±2.2	20/35
统计值		t＝0.199	χ²＝0.037	t＝0.253	t＝0.488	χ²＝0.940
P值		>0.05	>0.05	>0.05	>0.05	>0.05

组别	例数	年龄[岁，(±s)]	性别(男/女)	BMI [kg/m²，(±s)]	膝内翻角[°，(±s)]	K-L分型(Ⅲ/Ⅳ)
观察组	55	66.5±7.8	25/30	23.7±4.1	9.5±2.1	25/30
对照组	55	66.8±8.0	24/31	23.9±4.2	9.7±2.2	20/35
统计值		t＝0.199	χ²＝0.037	t＝0.253	t＝0.488	χ²＝0.940
P值		>0.05	>0.05	>0.05	>0.05	>0.05

组别	例数	手术时间(min)	切口长度(cm)	术中出血量(ml)	住院时间(d)	住院费用(千元)
观察组	55	52.5±6.1	3.6±0.6	27.9±7.4	5.1±1.1	7.1±1.0
对照组	55	105.7±16.9	12.5±1.7	118.7±10.6	15.5±3.4	3.3±3.1
t值		8.712	9.251	9.435	8.987	9.296
P值		<0.01	<0.01	<0.01	<0.01	<0.01

组别	例数	手术时间(min)	切口长度(cm)	术中出血量(ml)	住院时间(d)	住院费用(千元)
观察组	55	52.5±6.1	3.6±0.6	27.9±7.4	5.1±1.1	7.1±1.0
对照组	55	105.7±16.9	12.5±1.7	118.7±10.6	15.5±3.4	3.3±3.1
t值		8.712	9.251	9.435	8.987	9.296
P值		<0.01	<0.01	<0.01	<0.01	<0.01

组别	例数	VAS		t值	P值
组别	例数	术前	术后3个月	t值	P值
观察组	55	7.9±1.7	1.0±0.2	7.692	<0.01
对照组	55	7.9±1.6	1.0±0.3	7.639	<0.01
t值		0.201	0.258
P值		>0.05	>0.05
组别	例数	HSS		t值	P值
组别	例数	术前	术后3个月	t值	P值
观察组	55	45.2±12.3	83.4±11.7	7.802	<0.01
对照组	55	45.7±12.6	82.7±11.3	7.787	<0.01
t值		0.274	0.401
P值		>0.05	>0.05

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