A few small cuts are enough to replace total knee replacement

High Fibular Osteotomy (HFO), a minimal surgery below knee, is revolutionizing the treatment of osteoarthritis

New Delhi: Thanks to a dog cheap treatment catching up fast, knee replacement may be passé sooner than later. 

The name of the surging surgical technique which is almost replacing the need for total knee replacement is High Fibular Osteotomy (HFO). The name may sound a bit intimidating but it is as simple as ABC.

A few small cuts and just half an hour – and lo and behold! Your excruciating knee pain disappears to your great sigh of relief and you walk home in the evening same day quite normally after the minimal intervention. Evidence of its efficacy has been piling up fast and is likely to soon edge out knee replacement as the only treatment of knee osteoarthritis.

The patient watches the whole process as making him unconscious is not needed. Putting it simply, knee and area around it is anaesthetized; just one inch incision in the side of the leg is made three inches below knee; then a small portion of supporting bone structure fibula is cut. The same process is repeated for the second knee.

Talking to Medicare News, Dr Subhash Shalya, a renowned Orthopaedic Surgeon and proponent of this brief but very efficacious technique, said, ‘In fact, despite their being such a simple, cheap and efficacious technique as HFO, knee replacement is being thrust upon patients of knee osteoarthritis. Only one percent of a thousand needs knee replacement, the rest can be effectively taken care of by HFO. But 50 percent of them are advised knee replacement, out of which 10 percent fall for it. The total knee replacement is only for patients in the fourth stage of osteoarthritis’

Dr Shalya, Director, Bone Joints Care centre, Sarita Vihar, further said, ‘HFO is a godsend for those patients who are through excruciating knee pain, waiting for knee replacement but cannot go for it due to its prohibitive cost. Total knee replacement incurs cost anywhere between Rs 4 and 5 lakh. Compared to this, you can have HFO just for a song, at only Rs 40- 45 thousands.’

Dr Shalya, former Ortho doc at Apollo and Fortis, adds, ‘Knee replacement is a very complex procedure and entails a risk of infection which means complete loss of leg. About 4% of knee replacement cases confront infection episode. But in HFO, there is no question of infection. The bonus in HFO is that after this one can squat while ones going for knee replacement cannot. If you are of 30 -40 years of age and go for knee replacement, you would need revision replacement after 10-15 years.’

‘Second knee replacement incurs exorbitant Rs 7 lakh but lasts only for three years. Then you cannot have 3rd one which means you would be without legs if you live longer than 60 years of age. HFO can at least delay the need of knee replacement until the age when you have it; you do not need revision till you live. But if the patient heeds some advices that we give after this procedure, there would never arise a need of knee replacement’, he said.

In Japan, China and other countries, HFO is fast becoming the first line of treatment of osteoarthritis, not knee replacement. Even patients aged 70 are benefitting from this simple treatment. Clinical evidences of thousands of people vouch for hundred percent success.

HFO is better than knee replacement in many ways. First, Knee is not opened, no blood transfusion is needed. Only two stitches, nothing is put inside leg, nothing fitted from outside. So there is no question of infection. This procedure is also called Proximal Fibular Osteotomy (PFO). Even a patient aged 30-40 can go for this done. In about this age, the knee problem starts in many people. People suffering from serious life style disease like diabetes, high blood pressure and thyroid are not fit for knee replacement. For them HFO is the best option.


Please enter your comment!
Please enter your name here