Arthroscopic debridement combined with proximal fibular osteotomy in medial tibial articular genu osteoarthritis treatment: systematic review and meta-analysis

BACKGROUND We performed a systematic review and meta-analysis to evaluate the therapeutic effects of arthroscopic debridement and proximal fibular osteotomy (AD & PFO) on medial tibial articular genu osteoarthritis (MTAGO), so as to provide a theoretical reference for clinical surgical analgesia for patients. METHODS We searched and screened randomized controlled trials (RCTs) focusing on AD & PFO on MTAGO surgical analgesia published before December 31, 2020 in English databases including PubMed, Embase, Medline, Ovid, Springer, and Web of Science. The Cochrane Handbook for Systematic Reviews of Intervention 5.0.2 was adopted for bias risk assessment, and Review Manager 5.3 was used to conduct the meta-analysis. RESULTS Twelve eligible studies were included, involving 765 research subjects. The meta-analysis results indicated that, relative to control group, satisfaction was markedly increased [mean difference (MD) =3.10; 95% confidence interval (CI), (1.48 to 6.51); Z=3; P=0.003], adverse reactions were reduced [MD =0.33; 95% CI, (0.08 to 1.32); Z=1.56; P=0.12] the hospital special surgery (HSS) score was lower [MD =5.37; 95% CI, (3.18 to 7.55); Z=4.82; P<0.00001], the visual analogue scale (VAS) score decreased [MD =-1.68; 95% CI, (-2.22 to -1.13); Z=6.01; P<0.00001], and the Knee Society score (KSS) was reduced [MD =6.16; 95% CI, (3.85 to 8.47); Z=5.23; P<0.00001]. However, the difference in the femoro-tibial (FT) angle between the control and study groups was not statistically considerable [MD =0.14; 95% CI, (-6.22 to 6.49); Z=0.04; P=0.97]. DISCUSSION The combined adoption of AD & PFO for MTAGO surgical analgesia can reduce the HSS, KSS, and VAS scores of patients. The postoperative analgesia effect is good, and effectively reduces pain and adverse reactions in patients. Thus, it is suitable for analgesia in MTAGO.