Proximal fibular osteotomy: Systematic review on its outcomes

Table 1 Compilation of results from the selected clinical studies on proximal fibular osteotomy

No.	Ref.	Country	Year	Cases, n	Grade of osteoarthritis	Outcome score	Follow up period	Complications	Modified Colemans methodological quality assessment score
1	Yang et al[6]	China	2015	156	Not mentioned	KSS	49	CPN palsy = 2 nos; SPN palsy = 2 nos; All resolved	76
2	Zou et al[7]	China	2017	92	Grade 1, 2-30; grade 3, 4-10	JOA	25	NVI = 1; Fracture = 1; Recurrent deformity = 1	68
3	Wang et al[8]	China	2017	47	Not mentioned	KSS	12	Not available	63
4	Lu et al[9]	China	2018	31	Ahlback grade 1	HSS	24	SPN palsy = 1	53
5	Liu et al[10]	China	2018	111	Grade 2 = 17; Grade = 47; Grade = 47	KSS	12	Not available	68
6	Nie et al[11]	China	2018	16	Grade 2 = 3; Grade 3 = 16	HSS	12	Not available	63
7	Qin et al[12]	China	2018	67	KL score more than 2 with varus deformity	HSS	36	SPN palsy = 8	71
8	Utomo et al[13]	Indonesia	2018	15	All cases were grade 4	OKS	Immediate postoperative period only	Not available	51

KSS: American Knee Society Score; JOA: Japanese Orthopaedic Association Score; HSS: Hospital for Special Surgery Score; OKS: Oxford Knee Score; KL Score: Kellegren-Lawrence Score; CPN: Common peroneal nerve; SPN: Superficial peroneal nerve.

Table 2 Compilation of the biomechanical studies on proximal fibular osteotomy

No.	Ref.	Country	Year	Type of study	Cases, n	Medial compartment unloading	Remarks
1	Yazdi et al[14]	Iran	2015	Cadaveric study	6	Yes	Increase in pressure of lateral compartment
2	Huang et al[15]	China	2017	Clinical study with gait analysis	1	Yes	Reduction in knee pain due to increasing femoral valgus, femoral external rotation and distal translation of knee
3	Baldini et al[16]	United States	2018	Cadaveric study	10	Yes	A decrease in lateral compartment as well as ankle joint pressure was noted
4	Nie et al[11]	China	2018	Clinical study with gait analysis and dynamic musculoskeletal analysis	29 patient vs 20 controls	Yes	Decreased knee adduction moment was observed
5	Wang et al[17]	China	2019	Retrospective study with radiographic analysis	560 knees	Yes	Reduction in knee adduction moments and rebalance the biceps-proximal fibula-peroneus longus complex

Table 3 Predictive factors affecting outcome of proximal fibular osteotomy

Radiological parameters	Clinical parameters
Medial joint space	Preoperative functional score
CP angle	Body mass index
HKA angle
Settlement value

CP angle: Condyle plateau angle; HKA angle: Hip knee ankle angle.