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2022, Number 3

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Ortho-tips 2022; 18 (3)

Fibular diaphysectomy in the treatment of patients diagnosed with knee osteoarthritis grade II-III Kellgren-Lawrence and genu varo in a hospital in Michoacan, Mexico

Téllez AIR, Reyes PR, Sánchez AR, Silva MJA, Arellano MJ, Gutiérrez-Mendoza I, López AL

Language: Spanish
References: 25
Page: 222-229
PDF size: 219.31 Kb.


ABSTRACT

Introduction: Knee osteoarthritis is one of the main causes of musculoskeletal pain that leads to disability. A large percentage is accompanied by genu varus. Total knee arthroplasty (TKA) is not an option in young patients and high tibial osteotomy (HTO); although it is accepted in young people, is not free of complications. Fibular diaphysectomy (FD) is a simple and safe option that can relieve pain and improve function. Objectives: To describe clinical and radiographic results in patients with Kellgren-Lawrence grade II-III knee osteoarthritis and genu varus treated with FD. Material and methods: Patients undergoing PD for medial compartment gonarthrosis were included. Pain and functionality were evaluated preoperatively, immediate postoperatively and at 3, 6, 12, 18 and 24 months. Radiographically, medial and lateral joint height, joint space proportion, as well as the femoro-tibial angle and condyle plateau were evaluated preoperatively, at 24 hours and at 24 months. A value of p < 0.05 was considered significant. Results: 20 patients were analyzed. Pain (VAS 7 [6-8] vs 3 [3-3] preoperative and immediate postoperative p ≤ 0.001), functionality (KSS 45 [40-49] vs 74 [66-78] preoperative and immediate postoperative, p = 0.001 and WOMAC 59 ± 3 vs 12 ± 1 preoperatively and immediately postoperatively, p ≤ 0.001). At 24 months they had an increase in the height of the medial compartment compared to the preoperative one (2.5 ± 0.5 vs 2.2 ± 0.6 mm, p = 0.004). The femoro-tibial angle (174 ± 1 vs 178 ± 1 degrees, preoperative and immediate postoperative p ≤ 0.001). Conclusions: FD can significantly improve pain and function in patients with Kellgren-Lawrence grade II-III knee osteoarthritis and genu varus.


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