Proximal Fibular Osteotomy: A Refined Surgical Technique for Medial Compartment Knee Osteoarthritis

Proximal fibular osteotomy is a minimally invasive and cost-effective option for medial compartment knee osteoarthritis. This refined technique, performed under spinal anesthesia using Henry's posterolateral approach, involves a small incision approximately 10 cm distal to the fibular head, careful dissection through the peroneus longus plane, and osteotomy with a narrow saw blade protected by a distal osteotome. These modifications minimize soft tissue trauma and safeguard adjacent neurovascular structures. Early outcomes show pain relief, functional improvement, and correction of femorotibial angle. Immediate mobilization and rapid discharge highlight the safety, reproducibility, and clinical value of this approach.