A self-controlled study on the early effectiveness of proximal fibular osteotomy and surface replacement of the knee joint in the treatment of knee osteoarthritis for elderly patients
Guan Jianzhong*, Zhou Jiansheng, Xiao Yuzhou, Wu Min, Chen Xiaotian, Wang Zhaodong, Dai Xiusong, Zhou Xinshe, Sun Zhenyu.
*Department of Orthopaedics, the First Affiliated Hospital of Bengbu Medical College, Anhui Key Laboratory of Tissue Transplantation, Bengbu 233004, China
Abstract：Objective To explore the early clinical effectiveness of proximal fibular osteotomy and surface replacement of the knee joint in the treatment of knee osteoarthritis accompanied by genu varus deformity for elderly patients.Methods From November 2014 to February 2015, a prospective self-controlled study was conducted in the Department of Orthopaedics of the First Affiliated Hospital of Bengbu Medical College to observe the early effectiveness of proximal fibular osteotomy of the knee joint on one side (in the group who received osteotomy) and surface replacement of the knee joint on the other side (in the group who received replacement) in the treatment for 10 elderly patients with osteoarthritis accompanied by genu varus deformity in the knees on both sides. Of the 10 patients, 2 were males, and 8 were females. Their ages ranged from 55 to 75 years. During preoperative and postoperative follow-ups, the patients′ pain and function were evaluated by using the visual analog scale (VAS), the Hospital for Special Surgery (HSS) knee rating scale and the American Knee Society Score (KSS) scale. SPSS 21.0 software was used to perform a statistical analysis as well.Results All the patients experienced smooth surgery and postoperative follow-ups for 6-9 months. Before surgery, the differences of both the pain and function status in the osteotomy group and replacement group were not statistically significant (all P values>0.05). After surgery, both the pain and function status were improved markedly in the osteotomy group and replacement group. When the patients were conducted the final follow-up, their VAS scores, HSS scores as well as KSS clinical scores and function scores on both sides improved markedly than those before surgery, and the differences were statistically significant (all P values<0.01), while the final follow-up after surgery in the 2 groups showed that all aforementioned scores were not statistically significant (all P values>0.05).Conclusions Proximal fibular osteotomy can remarkably alleviate the pain and improve the function in patients with knee osteoarthritis accompanied by genu varus deformity, and therefore, it is a safe and effective minimally invasive surgical technique.
官建中, 周建生, 肖玉周, 吴敏, 陈笑天, 王照东, 代秀松, 周新社, 孙震宇. 腓骨近端截骨与膝关节表面置换治疗膝关节骨关节炎早期疗效的自身对照研究[J]. 中华解剖与临床杂志, 2016, 21(2): 129-132.
Guan Jianzhong, Zhou Jiansheng, Xiao Yuzhou, Wu Min, Chen Xiaotian, Wang Zhaodong, Dai Xiusong, Zhou Xinshe, Sun Zhenyu.. A self-controlled study on the early effectiveness of proximal fibular osteotomy and surface replacement of the knee joint in the treatment of knee osteoarthritis for elderly patients. Chinese Journal of Anatomy and Clinics, 2016, 21(2): 129-132.
Johnson DR, Dennis DA, Kindsfater KA, et al. Evaluation of total knee arthroplasty performed with and without computer navigation: a bilateral total knee arthroplasty study[J]. J Arthroplasty, 2013, 28(3): 455-458. DOI:10.1016/j.arth.2012.06.026
[2]
Patel AR, Talati RK, Yaffe MA, et al. Femoral component rotation in total knee arthroplasty: an MRI-based evaluation of our options[J]. J Arthroplasty, 2014, 29(8): 1666-1670. DOI:10.1016/j.arth.2014.02.033
[3]
Morris MJ, Lombardi AV Jr, Berend KR, et al. Clinical results of patellofemoral arthroplasty[J]. J Arthroplasty, 2013, 28(9 Suppl): 199-201. DOI:10.1016/j.arth.2013.05.012
[4]
Mont MA, Johnson AJ, Naziri Q, et al. Patellofemoral arthroplasty: 7-year mean follow-up[J]. J Arthroplasty, 2012, 27(3): 358-361. DOI:10.1016/j.arth.2011.07.010
[5]
Egidy CC, Sherman SL, Macdessi SJ, et al. Long-term survivorship of a unicondylar knee replacement-a case report[J]. Knee, 2012, 19(6):944-947. DOI:10.1016/j.knee.2012.03.015
[6]
Price AJ, Svard U. A second decade lifetable survival analysis of the Oxford unicompartmental knee arthroplasty[J]. Clin Orthop Relat Res, 2011, 469(1): 174-179. DOI:10.1007/s11999-010-1506-2
[7]
Siparsky P, Ryzewicz M, Peterson B, et al. Arthroscopic treatment of osteoarthritis of the knee: are there any evidence-based indications？[J]. Clin Orthop Relat Res, 2007, 455: 107-112
[8]
Steadman JR, Briggs KK, Rodrigo JJ, et al. Outcomes of microfracture for traumatic chondral defects of the knee: average 11-year follow-up[J]. Arthroscopy, 2003, 19(5): 477-484. DOI:10.1053/jars.2003.50112
[9]
Hangody L, Vásárhelyi G, Hangody LR, et al. Autologous osteochondral grafting-technique and long-term results[J]. Injury, 2008, 39(Suppl 1): S32-S39. DOI:10.1016/j.injury.2008.01.041
[10]
Wagner M, Frenk A, Frigg R. New concepts for bone fracture treatment and the Locking Compression Plate[J]. Surg Technol Int, 2004, 12: 271-277
Yang ZY, Chen W, Li CX, et al. Medial compartment decompression by fibular osteotomy to treat medial compartment knee osteoarthritis: a pilot study[J]. Orthopedics, 2015, 38(12): e1110-e1114. DOI:10.3928/01477447-20151120-08
2016, Vol. 21 
