Proximal fibular osteotomy definitively ameliorates medial compartment knee osteoarthritis: A finite element analysis

Objective: This study was designed to explore the biomechanical impacts of the proximal fibular osteotomy (PFO) on medial compartment knee osteoarthritis (KOA). Furthermore, this study utilized finite element analysis (FEA) to examine the biomechanical impacts of PFO on medial compartment KOA both pre- and post-surgery. Methods: Fifteen individuals with medial compartment KOA were selected randomly. Three-dimensional reconstruction software, coupled with FEA software, was employed to model PFO, allowing observation of changes in stress distribution, peak stress, and contact area of articular cartilage in femoral cartilage, tibial plateau cartilage, and meniscus before and after PFO. Results: After PFO, significant changes in peak stress and stress distribution in the knee joint (KJ) were observed. The stress distribution shifts notably from the medial side to the lateral side. A significant reduction in peak values was observed in the medial femoral cartilage (changing from 1.91 f 0.44 to 1.40 f 0.14), medial meniscus (2.89 f 0.72 to 2.05 f 0.49), and medial tibial plateau cartilage (2.25 f 0.65 to 1.60 f 0.38). On the contrary, an increase in these metrics was recorded in the lateral femoral cartilage (changing from 1.10 f 0.32 to 1.59 f 0.30), lateral meniscus (1.82 f 0.58 to 2.49 f 0.60), and lateral tibial plateau cartilage (0.95 f 0.21 to 1.40 f 0.26). In addition, the stress distribution area of articular cartilage was reduced significantly in the medial dimension (346.25 f 55.66 to 267.05 f 51.05) and increased in the lateral dimension (219.35 f 38.89 to 333.25 f 29.90). Conclusion: PFO demonstrates effectiveness in alleviating stress within the medial compartment of the KJ, presenting a straightforward and efficacious approach for managing medial compartment KOA.