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Review
. 2024 Jun 27:54:102473.
doi: 10.1016/j.jcot.2024.102473. eCollection 2024 Jul.

Severity of knee osteoarthritis does not affect clinical outcomes following proximal fibular osteotomy - A systematic review and pooled analysis

Zhen Jonathan Liang  1   2 , Don Thong Siang Koh  3   2 , Junwei Soong  3   2 , Kong Hwee Lee  3   2 , Hamid Rahmatullah Bin Abd Razak  4   5   2
Affiliations
Review

Severity of knee osteoarthritis does not affect clinical outcomes following proximal fibular osteotomy - A systematic review and pooled analysis

Zhen Jonathan Liang et al. J Clin Orthop Trauma. .

Erratum in

Abstract

Background & aims: Knee osteoarthritis (KOA) is a progressive degenerative disease of chronic nature. The mainstay of surgical management for KOA would be total knee arthroplasty. Joint preserving options like High Tibial Osteotomy (HTO) and Proximal Fibular Osteotomy (PFO) have been offered as an inexpensive option by knee preservation surgeons. Current literature on PFO outcomes lack of clarity for specific indications for offering PFO based on degree of severity of KOA. Therefore, this systematic review aims to critically evaluate clinical and radiological outcomes of PFO stratified by severity of KOA.

Methods: PubMed, Scopus, CINAHL and Google Scholar databases were searched. Eligible studies included those published up till August 2023, with 271 studies obtained. After duplicate removal, title-abstract screening, and a full text screen based on inclusion and exclusion criteria, 11 papers were included. 46 papers were further identified from snowballing of 7 existing systematic reviews, with 2 additional papers subsequently included.

Results: 13 included articles analysed 788 knees. Our study found that indications based on KL grading of KOA do not seem to differ in terms of post-operative clinical outcomes (VAS score) and radiological measures also found that hip knee alignment was improved regardless of KL grading of KOA. Additionally, the most common post-operative complication reported was deep peroneal nerve palsy.

Conclusion: PFO is a viable knee joint preserving surgery for medial compartment KOA, however given the high risk for complications reported in the literature, surgeons should pay close attention to the neuroanatomical landmarks and techniques to avoid neurovascular injury.

Keywords: Knee osteoarthritis; Proximal fibular osteotomy.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
PRISMA flowchart.
See this image and copyright information in PMC

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