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Upper partial fibulectomy improves knee biomechanics and function and decreases knee pain of osteoarthritis: A pilot and biomechanical study.

Publication ,  Journal Article
Nie, Y; Ma, J; Huang, Z; Xu, B; Tang, S; Shen, B; Kraus, VB; Pei, F
Published in: J Biomech
April 11, 2018

To investigate the change in clinical outcomes and biomechanical properties of the knee in response to upper partial fibulectomy. Sixteen patients with medial compartment knee osteoarthritis (KOA) underwent upper partial fibulectomy. Visual analog scale (VAS) pain, the hospital for special surgery knee score (HSS), hip-knee-ankle (HKA) angle (measured in the frontal plane), and flexion/extension range of motion of the knee were assessed before and up to 6 months after surgery. Patients were evaluated for gait parameters and overall peak knee adduction moment (KAM). Patient-specific finite element knee models were developed to investigate changes in load in response to fibulectomy. Both VAS pain and HSS score were significantly improved (P < .001) one day after surgery and steadily improved during the subsequent 6 months. HKA angle improved (P = .006) immediately and remained stable by 3 months after surgery. A significant inverse relationship (R = -0.528, P = .012) between the overall peak KAM (decreased by 19.1%) and the HKA (increased by 1.24° from a more varus to more neutral alignment) angle was observed. The minor load supported by the fibula preoperatively was spread post-operatively over the cortical bone of the tibial shaft. The mean stress in the medial tibial plateau was significantly decreased (P < .001), with a portion of the stress transferred to the posterior-lateral region of the tibial plateau after upper partial fibulectomy. This pilot study provides objective 3D gait and plausible biomechanical evidence for the improvement in clinical symptoms from partial upper fibulectomy.

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Published In

J Biomech

DOI

EISSN

1873-2380

Publication Date

April 11, 2018

Volume

71

Start / End Page

22 / 29

Location

United States

Related Subject Headings

  • Tibia
  • Pilot Projects
  • Pain
  • Osteotomy
  • Osteoarthritis, Knee
  • Middle Aged
  • Male
  • Knee Joint
  • Humans
  • Gait
 

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Nie, Y., Ma, J., Huang, Z., Xu, B., Tang, S., Shen, B., … Pei, F. (2018). Upper partial fibulectomy improves knee biomechanics and function and decreases knee pain of osteoarthritis: A pilot and biomechanical study. J Biomech, 71, 22–29. https://doi.org/10.1016/j.jbiomech.2017.12.004
Nie, Yong, Jun Ma, ZeYu Huang, Bin Xu, Shuo Tang, Bin Shen, Virginia Byers Kraus, and FuXing Pei. “Upper partial fibulectomy improves knee biomechanics and function and decreases knee pain of osteoarthritis: A pilot and biomechanical study.J Biomech 71 (April 11, 2018): 22–29. https://doi.org/10.1016/j.jbiomech.2017.12.004.
Nie, Yong, et al. “Upper partial fibulectomy improves knee biomechanics and function and decreases knee pain of osteoarthritis: A pilot and biomechanical study.J Biomech, vol. 71, Apr. 2018, pp. 22–29. Pubmed, doi:10.1016/j.jbiomech.2017.12.004.
Nie Y, Ma J, Huang Z, Xu B, Tang S, Shen B, Kraus VB, Pei F. Upper partial fibulectomy improves knee biomechanics and function and decreases knee pain of osteoarthritis: A pilot and biomechanical study. J Biomech. 2018 Apr 11;71:22–29.
Journal cover image

Published In

J Biomech

DOI

EISSN

1873-2380

Publication Date

April 11, 2018

Volume

71

Start / End Page

22 / 29

Location

United States

Related Subject Headings

  • Tibia
  • Pilot Projects
  • Pain
  • Osteotomy
  • Osteoarthritis, Knee
  • Middle Aged
  • Male
  • Knee Joint
  • Humans
  • Gait