Proximal Fibular Osteotomy

Proximal Fibular Osteotomy is a minimally invasive surgical technique which is helpful in a small group of patients with Osteo-Arthritis of the knee joint. The ideal patients who are a candidate for PFO should meet following criteria:

  • Patients with grade 3 and 4 arthritis with a lean body mass.
  • Patients with only Uni Or Medial compartment arthritis with “Maintained” Lateral Joint Space.
  • Bowing/Varus deformity <25 degrees on a scanogram/Xrays.

The above mentioned procedure has lately come into vogue as a substitute daycare procedure to High Tibial Osteotomy (HTO) to buy time before getting a knee replcement procedure. A small piece of bone is removed in this procedure under Spinal/Regional anaesthesia and the patient is mobilised on the same evening.

Various patients have good to excellent relief from painful gait. The improvement in pain depends solely on fulfillment of the fore-mentioned criteria. There is reported improvement in pain upto 6 months after the procedure with most patients being able to avoid a replacement for few months to years.

The Surgical procedure usually done under flouroscopic guidance and takes about 15 -30 minutes. The procedure makes use of a 4-6 cms incision over the upper outer side of the leg. Unlike other surgeries, the procedure is not completely free of risks. The risks involved include:

  • Post-operative pain
  • Nerve Related compliecations (1-8%)
  • Hematoma formation

1st post operative day walking with excellent functional recovery. Selection of candidates for surgery is crucial for results. Not every patient can benefit from the surgery.


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