The middle-term results of proximal fibular osteotomy and percutaneous drilling in the treatment of gonarthrosis

Year 2025, Volume: 42 Issue: 3, 296 - 302, 30.09.2025

Sefa Erdem Karapınar , Abdurahman Bayindir , Recep Dinçer , Tolga Atay , Yakup Barbaros Baykal , Vecihi Kırdemir , Metin Lutfi Baydar

Abstract

This study aimed to investigate the radiographic and functional results of proximal fibular osteotomy (PFO) and percutaneous drilling techniques performed on patients with medial gonarthrosis. This study included 420 knees of 230 patients who underwent surgery in the orthopaedics and traumatology clinic between January 2019 and January 2022. The demographic data of the patients, including age and body mass index (BMI), were recorded together with the joint range of movement, joint space ratio and femorotibial angles. The patients were evaluated using the VAS for pain, WOMAC, Lysholm Knee Score for functionality, and the Short-Form 12 for quality of life. The patients treated with PFO and subchondral drilling comprised 46% females and 54% males with a mean age of 57.08 years, a mean BMI of 31.5 kg/m2, and a mean follow-up period of 24.96±6.05 months. Compared to the preoperative period, there was a statistically significant improvement in postoperative pain, functionality, quality of life, joint range of movement, joint space ratio, and femorotibial angle (p<0.001 for all). When the patients were grouped according to BMI, those with a BMI< 31.5 kg/m² demonstrated a greater improvement in VAS scores. Based on the study results, the implementation of PFO as an initial intervention—prior to procedures such as knee prosthesis and high tibial osteotomy (HTO) appeared to yield favorable outcomes for patients with medial gonarthrosis and a moderate degree of varus deformity.

Keywords

Genu varus , Medial Gonarthrosis , Proximal Fibular Osteotomy , Subchondral Drilling

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