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Growth modulation in idiopathic angular knee deformities: is it predictable?

B Danino1,2, R Rödl3, J E Herzenberg4

  • 1The Department of Pediatric Orthopaedics, Dana Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.

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|July 18, 2019
PubMed
Summary
This summary is machine-generated.

Temporal hemiepiphysiodesis effectively corrects idiopathic knee deformities, with faster correction rates in the femur than the tibia. Valgus deformities show quicker correction than varus, enabling predictable outcomes.

Keywords:
guided growthhemiepiphysiodesisidiopathic knee valgusidiopathic knee varuslimb deformity

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Area of Science:

  • Orthopedic surgery
  • Pediatric orthopedics
  • Skeletal growth modulation

Background:

  • Idiopathic knee varus/valgus deformities require precise correction strategies.
  • Temporal hemiepiphysiodesis is a surgical technique to guide bone growth.
  • Understanding the timing and spatial progression of correction is crucial for optimizing outcomes.

Purpose of the Study:

  • To analyze the temporal and spatial sequence of correction after temporal hemiepiphysiodesis for idiopathic knee varus and valgus.
  • To identify factors influencing the rate and success of correction.
  • To develop a predictive tool for monitoring hemiepiphysiodesis outcomes.

Main Methods:

  • Retrospective multicenter study involving 372 physes in 206 patients.
  • Calculation of the average rate of correction (ROC) for femoral and tibial physes.
  • Univariate and multivariate analyses to assess influencing factors (age, deformity type/magnitude).

Main Results:

  • High success rates: 93% femoral and 92% tibial physes achieved target mechanical angles (mLDFA/mMPTA).
  • Femoral correction (0.85°/month) was faster than tibial (0.78°/month).
  • Valgus correction in the femur (0.90°/month) was faster than varus (0.77°/month).
  • A predictive constant was derived, showing significant correlation for mLDFA valgus and all mMPTA corrections.

Conclusions:

  • The femur corrects faster than the tibia in hemiepiphysiodesis.
  • Valgus deformities correct more rapidly than varus deformities.
  • Hemiepiphysiodesis for idiopathic knee angular deformities is predictable, especially valgus correction in the distal femur/proximal tibia and varus in the tibia.
  • A novel constant aids in predicting and monitoring hemiepiphysiodesis correction amounts.