الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Osteoarthritis is the commonest form of arthritis affecting millions of people worldwide. Osteoarthritis is the most common cause of disability in the older population due to pain and limitations of movement. Osteoarthritis prevalence increase with age; 80% of older patients >65 years old have symptomatic osteoarthritis of at least one joint and x-ray changes are present in over 50% of patients over 60 years old. The objective of this study was to compare the efficacy of PFO alone or conducted with arthroscopic lavage and debridement in treatment, decreasing pain and improving functions of medial compartment knee OA in elderly people. The present prospective study was started upon 42 patients which were previously diagnosed as having medial compartment knee OA with history of pain, crepitus and difficulty walking, with limitation of movement, stiffness and deformity, who attended outpatient clinic in Orthopedic department of Tanta University Hospitals. The selected cases had been randomized into two matched groups regarding age, sex, BMI and degree of osteoarthritis with age starts from 45 years old; group (A) 21 patients undergone proximal fibular osteotomy alone. group (B) 21 had undergone proximal fibular osteotomy conducted with arthroscopic lavage and debridement. In group (A) which undergone PFO alone; two patients refused to follow the study protocol and one patient had a postoperative symptom of deep peroneal nerve injury, which manifested mainly by hypoesthesia at the first web space of the foot weakness of extensor digitorum brevis muscle. One patient in group (B) which undergone PFO with arthroscopic lavage and debridement refused following the study protocol and one suffered from skin rash and surgical site infection. And all were excluded from the data analysis. So the end number of cases after exclusion of cases who didn’t follow the study protocol was 37 cases. There were no significance differences between two standard groups as regards the characteristics data (age, sex, BMI and hemoglobin concentration). Comparing the two study groups regarding mean duration of unilateral PFO alone or with arthroscopy of the two study groups, it was found that it is not time-consuming operation. Latency and more time may be consumed duo to technical problems in installing the knee arthroscope. The mean visual analogue scale scores of the two study groups during the period of the study. The (VAS) was assessed and recorded in the 2 study groups pre and post operatively. It was improved in the two study groups with better results in group (B) but without statistically significant analysis. The knee sub scores of (AKSS) in of was assessed in both study groups pre and post operatively. It was obviously improved in both study groups with more improvement in group (B) with no statistically significant difference between them The mean function sub score of the (AKSS) for the two study groups was recorded preoperatively and postoperatively which was improved postoperatively in both groups. The post-operative score for group (B) shows better results than that of group (A), with no statistically significant difference between them. The FTA of the two study groups was measured preoperatively and postoperatively which decreased post operatively for both of the study groups, with no statistically significant difference between them. The mean ratio between the (medial/lateral compartments) of the two study groups increased post operatively for both of the study groups which is due to opening of medial joint space postoperatively and decrease in lateral joint space, with no statistically significant difference between the two groups. So, results of the study proved efficacy of PFO alone or conducted with arthroscopic lavage and debridement in treatment, decreasing pain and improving functions of medial compartment knee OA in elderly people with best results in group (B) which undergone PFO and arthroscopic lavage and debridement.