Proximal Fibular Osteotomy Versus High Tibial Osteotomy: An In-silico Finite Element Study

Typical treatments against knee osteoarthritis (KOA) are performed surgically, such as knee arthroplasty or high tibial osteotomy (HTO). In recent years, Proximal Fibular Osteotomy (PFO) has been proposed as a solution against KOA. The biomechanical understanding of the effects of PFOs is herein investigated. The present study provides the fundamental data for the biomechanical description of this surgical technique, which has been numerically evaluated with finite element models against the HTO reversed-engineered in-silico model. PFO finite element models are digitally compared to in-vivo HTO surgical outcomes in their pre- and post-surgical state. The compliance between simulation and practical surgery outcomes could be improved using the subject end-results to iterate and customize the PFO in-silico model. Opportunities, procedures and restrictions of in-silico models are presented. In-silico approaches may lead the medical community to move faster, more confidently and more cost-effectively toward research discoveries than using traditional in-vitro and in-vivo approaches.