Radiological and Functional Outcomes of Proximal Fibular Osteotomy Performed under Local Anesthesia in Medial Compartment Osteoarthritis of the Knee: A Prospective Short-term Study

Introduction: Knee osteoarthritis (OA), often in the medial compartment, is commonly linked to biomechanical factors such as obesity and repetitive use. Proximal fibular osteotomy (PFO) is gaining orthopedic acceptance for relieving knee pain in medial OA. PFO offers fewer complications, a shorter recovery period, and minimal activity or weight-bearing restrictions, making it increasingly recognized as an effective treatment. The aim of the present study was carried out to describe radiological and clinical outcomes at 6 months in patients undergoing PFO for medial join OA of the knee. Patients and Methods: A prospective study with 18 cases with Grade 2 medial compartment OA cases underwent proximal partial fibulectomy under local anesthesia. Monitored for 6 months, clinical outcomes were assessed using the WOMAC score, American Knee Society Score, and visual analog scale (VAS), while radiological evaluations employed hip–knee–ankle (HKA) measurements and lateral/medial joint space ratios. Results: Patients, averaging 58.7 years, showed significant improvement in medial joint space (2.2–3.95 mm) post-PFO. The knee compartment ratio increased notably from 0.36 to 0.66 at 6 months. Realignment was evident, with the average HKA decreasing from 7.2° to 0.8°. VAS score improved from 8.2 to 2.46, and Knee Society Score (KSS) showed substantial improvement, indicating the beneficial effect of PFO. Conclusion: PFO under local anesthesia yields positive short-term outcomes, catering to the need for increased knee flexion, which is essential in activities such as deep squatting and cross-legged sitting and is common in some Asian cultures. The procedure also boasts advantages such as reduced operative time, quicker pain relief, and faster rehabilitation.