[A comparative study of the curative effect of proximal fibular osteotomy and single condylar replacement for the treatment of knee osteoarthritis of different severity].

ABSTRACT

OBJECTIVE: To compare the clinical effect of proximal fibular osteotomy (PFO) and single condyle replacement (UKA) in the treatment of knee osteoarthritis of different severity. METHODS: From June 2015 to September 2017, 53 patients with knee osteoarthritis were analyzed retrospectively. According to the operation mode, they were divided into PFO group (26 cases) and UKA group (27 cases) . According to Kellygren-Lawrence imaging classification standard：PFO group, 5 cases of gradeⅡ, 11 cases of grade Ⅲ, 10 cases of grade Ⅳ; UKA group, 7 cases of gradeⅡ, 9 cases of grade Ⅲ, 11 cases of grade Ⅳ. The amount of intraoperative bleeding, operation time and postoperative hospital stay were compared between the two groups. The patients were followed up regularly in the outpatient clinic before operation, 3 months after operation and 1 year after operation. The WOMAC score and the angle of tibiofemoral angle at each time point in the same group were compared, and the OMAC score and the angle of tibiofemoral angle at each time between the two groups were compared. RESULTS: Fifty-three patients were followed up for 12 to 24 (16.6±4.8) months. Compared with UKA group, PFO group had less intraoperative bleeding, shorter operative time and shorter postoperative hospital stay (P<0.05) . The scores of pain, stiffness and body function in UKA group were better than those in PFO group (P<0.05) . After 3 months and 1 year, the WOMAC index in PFO group was significantly improved (P<0.05) ; after 3 months and 1 year, the WOMAC index in UKA group was significantly better than that in PFO group (P<0.05) ; after 3 months, the WOMAC index in PFO group was significantly better than that in UKA group (P<0.05) . The tibiofemoral angle of gradeⅡand Ⅲ patients in both groups decreased gradually (P<0.05) ; the tibiofemoral angle of grade Ⅳ patients in UKA group was smaller than that of grade Ⅳ patients in PFO group (P<0.05) . CONCLUSION: Compared with UKA, PFO has the advantages of small trauma, fast recovery and low cost. The curative effect of PFO is equal to or more than UKA in the patients with gradeⅡand Ⅲ knee osteoarthritis. It is an alternative surgical method for the treatment of knee osteoarthritis.