Atahan Mehmet Okan, Gölgelioğlu Fatih, Yalın Mustafa, Gündoğdu Mehmet Cihat, Uzun Mehmet Fatih, Güney Ahmet
Department of Orthopedics and Traumatology, Afyonkarahisar State Hospital, 66000 Afyonkarahisar, Turkey.
Faculty of Medicine, Department of Orthopedics and Traumatology, Yozgat Bozok University, 66000 Yozgat, Turkey.
Indian J Orthop. 2025 Feb 24;59(4):530-538. doi: 10.1007/s43465-025-01348-y. eCollection 2025 Apr.
Proximal fibular osteotomy (PFO) and high tibial osteotomy (HTO) are two surgical options for treating varus deformities in knee osteoarthritis (KOA). While HTO provides more extensive correction, PFO offers a less invasive alternative. This study compares the radiologic and clinical outcomes of PFO and HTO to evaluate their relative efficacy.
A retrospective study was conducted with 120 patients, 60 undergoing PFO and 60 undergoing HTO, across two centers. Clinical outcomes were assessed using the Knee Society Score (KSS) and Visual Analogue Scale (VAS) for pain, while radiological outcomes were evaluated by measuring the hip-knee-ankle (HKA) angle. The complication rates were recorded, and multivariate regression analysis was performed to examine the factors influencing varus correction.
Both groups showed significant improvements in pain and function, with no major differences in clinical outcomes between PFO and HTO ( > 0.05). However, HTO provided greater correction of the varus deformity (10.5 ± 1.5° vs. 3.1 ± 1.6°, = 0.010). A higher proportion of PFO patients exhibited residual varus (> 3°) compared to those who underwent HTO (50% vs. 10%, = 0.003). Complication rates were higher in the HTO group, with non-union and tibial hinge fractures occurring in 7% and 8% of patients, respectively.
PFO is a less invasive option with fewer complications but provides less varus correction than HTO. Despite this, both techniques yield comparable clinical outcomes, indicating that PFO may be a viable alternative for patients with milder deformities or higher surgical risk.
近端腓骨截骨术（PFO）和高位胫骨截骨术（HTO）是治疗膝关节骨关节炎（KOA）内翻畸形的两种手术选择。虽然HTO能提供更广泛的矫正，但PFO是一种侵入性较小的替代方案。本研究比较了PFO和HTO的影像学和临床结果，以评估它们的相对疗效。
在两个中心对120例患者进行了一项回顾性研究，其中60例接受PFO，60例接受HTO。使用膝关节协会评分（KSS）和视觉模拟量表（VAS）评估疼痛的临床结果，同时通过测量髋-膝-踝（HKA）角评估影像学结果。记录并发症发生率，并进行多变量回归分析以检查影响内翻矫正的因素。
两组在疼痛和功能方面均有显著改善，PFO和HTO的临床结果无显著差异（>0.05）。然而，HTO对内翻畸形的矫正更大（10.5±1.5°对3.1±1.6°，P=0.010）。与接受HTO的患者相比，接受PFO的患者中残留内翻（>3°）的比例更高（50%对10%，P=0.003）。HTO组的并发症发生率更高，骨不连和胫骨铰链骨折分别发生在7%和8%的患者中。
PFO是一种侵入性较小、并发症较少的选择，但与HTO相比，其对内翻的矫正较少。尽管如此，两种技术产生的临床结果相当，这表明PFO可能是畸形较轻或手术风险较高患者的可行替代方案。
