Simultaneous knee arthroscopy and fibular ostectomy: a case report
Keywords:
AR- Artrosis de la rodilla OPP- Ostectomía proximal del peroné EDA- Enfermedad degenerativa articularAbstract
Background: knee is one of the joints most affected by osteoarthritis, associated to angular deformities especially the varus, which makes treatment even more difficult.
Objective: to show a case report of a patient with knee osteoarthritis and varus deformity treated by simultaneous arthroscopy and proximal fibular ostectomy.
Clinical case: a 64 year-old, white woman, without health morbid antecedents, was taken to the outpatient department complaining of left knee pain for a year, the pain gets worse with physical activities and reliefs with rest, pain killers and non steroidal anti-inflammatory drugs. Simple X Rays showed varus deformity of both knees more accentuated in the left one. Because of patient condition, she underwent surgery where it was performed a combined and simultaneous arthroscopy and proximal fibular ostectomy.
Conclusions: the technique is a useful, while combining two procedures in one, and it is feasible and reproducible in institutions with arthroscopic service training.
DeCS: OSTEOARTHRITIS, KNEE; GENU VARUM/surgery; ARTHROSCOPY/methods; OSTEOTOMY /methods; FIBULA /surgery.
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1.Boya H, Araç SS. Does severe osteoarthritis in knees with varus deformity alter the adductor ratio? Acta Orthop Traumatol Turc. 2017 Dec;51(6):437-41.
2.Amaratunga HA, Adikari SB, Dassanayake TL, Gamage J, Suraweera HJ. Relationship between the goniometric alignment and articular cartilage damage in knee osteoarthritis. Ceylon Med J. 2017 Sep; 62(3):167-74.
3.Iijima H, Fukutani N, Yamamoto Y, Hiraoka M, Miyanobu K, Jinnouchi M, et al. Association of varus thrust with prevalent patellofemoral osteoarthritis: a cross-sectional study. Gait Posture. 2017 Oct; 58:394-400.
4.Baier C, Benditz A, Koeck F, Keshmiri A, Grifka J, Maderbacher G. Different kinematics of knees with varus and valgus deformities. J Knee Surg. 2018 Mar; 31(3):264-9.
5.Niemeyer P, Stöhr A, Köhne M, Hochrein A. Medial opening wedge high tibial osteotomy. Oper Orthop Traumatol. 2017 Aug; 29(4):294-305.
6.Park CH, Bae DK, Kim KI, Lee JW, Song SJ. Serial changes in the joint space width and joint line convergence angle after closed-wedge high tibial osteotomy. Am J Sports Med. 2017 Dec; 45(14):3254-61.
7.Kim SH, Ro DH, Lee YM, Cho Y, Lee S, Lee MC. Factors associated with discrepancies between preoperatively planned and postoperative alignments in patients undergoing closed-wedge high tibial osteotomy. Knee. 2017 Oct; 24(5):1129-37.
8.van Outeren MV, Waarsing JH, Brouwer RW, Verhaar JAN, Reijman M, Bierma-Zeinstra SMA. Is a high tibial osteotomy (HTO) superior to non-surgical treatment in patients with varus malaligned medial knee osteoarthritis (OA)? A propensity matched study using 2 randomized controlled trial (RCT) datasets. Osteoarthritis Cartilage. 2017 Dec; 25(12):1988-93.
9.Salim R, Fogagnolo F, Perina MM, Rubio UM, Kfuri Junior M. Conventional plate and screws in medial opening-wedge high tibial osteotomy: are they sufficiently stable? A retrospective study. Rev Bras Ortop. 2017 Jan; 52(5):549-54.
10.Wang X, Wei L, Lv Z, Zhao B, Duan Z, Wu W, et al. Proximal fibular osteotomy: a new surgery for pain relief and improvement of joint function in patients with knee osteoarthritis. J Int Med Res. 2017 Feb; 45(1):282-9.
11.Bert TM, Bert JM. Arthroscopic approach to knee osteoarthritis. En: Sgaglione NA, Lubowitz JH, Provencher MT. The Knee: AANA Advance Arthroscopic Surgical Techniques. Thorofare: Slack Incorporated; 2016.p.189-96.
12.Lee OS, Ahn S, Ahn JH, Teo SH, Lee YS. Effectiveness of concurrent procedures during high tibial osteotomy for medial compartment osteoarthritis: a systematic review and meta-analysis. Arch Orthop Trauma Surg. 2018 Feb; 138(2):227-36.
13.Robbins SR, Melo LRS, Urban H, Deveza LA, Asher R, Johnson VL, et al. Stepped care approach for medial tibiofemoral osteoarthritis (STrEAMline): protocol for a randomised controlled trial. BMJ Open. 2017 Dec; 7(12):e018495.
14.Hanada M, Hoshino H, Koyama H, Matsuyama Y. Relationship between severity of knee osteoarthritis and radiography findings of lower limbs: a cross-sectional study from the TOEI survey. J Orthop. 2017 Aug; 14(4):484-8.
15.Pape D, Hoffmann A, Seil R. Imaging and preoperative planning for osteotomies around the knee. Oper Orthop Traumatol. 2017 Aug; 29(4):280-93.
16.Yang ZY, Chen W, Li CX, Wang J, Shao DC, Hou ZY, et al. Medial compartment decompression by fibular osteotomy to treat medial compartment knee osteoarthritis: a pilot study. Orthopedics. 2015 Dec; 38(12):e1110-4.
17.Yazdi H, Mallakzadeh M, Mohtajeb M, Farshidfar SS, Bagherty A, Givehchian B. The effect of partial fibulectomy on contact pressure of the knee: a cadaveric study. Eur J Orthop Surg Traumatol. 2014 Oct; 24(7):1285-9.
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22 julio 2025