A novel osteotomy tool reduces complications and improves operative efficiency in proximal fibular osteotomy for medial compartment knee osteoarthritis: a retrospective comparative study.

BACKGROUND

Proximal fibular osteotomy (PFO) is a surgical treatment for medial knee osteoarthritis (MKOA). This study aimed to evaluate the safety and efficacy of a novel instrument, the Threading Saw Pliers, compared to conventional techniques in performing PFO.

METHODS

Between February 2021 and February 2023, 80 patients undergoing PFO for MKOA were allocated into two groups based on the chronological introduction of the tool: the Modified group (using Threading Saw Pliers, n = 40) and the Conventional group (n = 40). Operating time, intraoperative blood loss, perioperative complications, Visual Analogue Scale (VAS) score, Knee Society Score (KSS), and Hospital for Special Surgery Knee Score (HSS) were assessed. The follow-up span over a time line of at least 12 months.

RESULTS

Baseline characteristics were similar between the two groups. The Modified group demonstrated a significantly shorter mean operating time (25.14 ± 8.11 vs. 55.33 ± 6.90 min, P < 0.001) and reduced mean blood loss (20.11 ± 30.29 vs. 101.19 ± 29.33 ml, P < 0.001). The overall perioperative complication rate was markedly lower in the Modified group (2.5% vs. 27.5%, P = 0.007). While VAS, KSS, and HSS scores showed significant improvement from preoperative values within each group at 6 and 12 months postoperatively (P < 0.05), there were no significant differences in these clinical outcomes between the two groups at either time point (P > 0.05).

CONCLUSIONS

The use of the Threading Saw Pliers in PFO is associated with superior perioperative safety, including reduced operating time, less blood loss, and fewer complications, while achieving equivalent mid-term clinical outcomes compared to conventional techniques. The Threading Saw Plier represents a valuable technical advancement for this procedure.