A brief review on proximal fibular osteotomy for treating medial compartment osteoarthritis of knee

Abstract

It was seen that Proximal fibular osteotomy (PFO) is a very simple to perform and a very low-cost surgery when compared to knee arthroplasty and high-tibial osteotomy and was seen to be useful in treating low socio-economic populations that cannot afford expensive surgical treatment methods. The literature available currently consists of mainly of case series and finds PFO useful in symptomatic improvement of medial compartment osteoarthritis. However, there is a lack of consensus regarding the functional outcome of this surgery and also the exact mechanism that is in action. This study was hence conducted to analyse all the evidence on proximal fibular osteotomy which is available, to know its benefits and the mechanisms in action. The theories like non-uniform settlement, slippage phenomenon, the too-many cortices theory, dynamic fibular distalization theory, the concept of competition of muscles, ground reaction vector readjustment theory are various mechanisms have been proposed previously. We have discussed these mechanisms and proposed directives for future research. However, to be sure of the benefits of this procedure when compared to other established treatment modalities, large trials and long-term follow-up studies are required.