Proximal fibular osteotomy (PFO) was defined to provide a treatment option for knee pain caused by gonarthrosis(1). Minor surgical procedure, low complication rate and dramatic pain relief were the main reasons for popularization of this procedure(2, 3). However, changes at the knee and ankle joint after PFO were not clarified objectively in the literature. We asked: 1) Does PFO change the maximum and average pressures at the medial and lateral chondral surface of the tibia plateau? 2) Are chondral surface stresses redistributed at the knee and ankle joint after PFO? 3)Does PFO change the distribution of total load on the knee joint? 4) Can PFO lead to change in alignment of lower limb?Abstract
Background
Questions/purposes
We treated 26 hips (24 consecutive patients) with residual dysplasia by a technique of incomplete triple pelvic osteotomy. The mean age of the patients was 21.6 years. The mean values for the pre-operative centre-edge angle of Wiberg, the refined centre-edge angle, the acetabular angle of Sharp, the modified acetabular angle and femoral head lateralisation were 7.7°, −3.1°, 49.3°, 53.2° and 17.2 mm, respectively. After a mean follow-up of 3.3 years they were 27.0°, 13.0°, 38.9°, 44.3° and 15.9 mm, respectively (p <
0.05). The osteoarthritic grading changed adversely in one hip. The mean pre-operative and latest Harris hip scores were 74.9 and 93.0, respectively (p <
0.05). This technique provides a stable osteotomy with maintenance of the posterior column which allows early mobilisation and minimal internal fixation. The technique is not complex and requires minimal blood transfusion. The use of an image intensifier is not necessary and harvesting of a subcristal bone graft avoids post-operative complications at the donor site.
