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Related Concept Videos

Growth of Cartilage and Bone Tissue01:27

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Chondrocytes form a temporary cartilaginous model by dividing and secreting a thick gel-like extracellular matrix. Once the chondrocytes undergo programmed cell death, osteoblasts enter the site of the cartilaginous model. The process of replacing the temporary cartilaginous model with bone in an ordered manner is called endochondral ossification. In endochondral ossification, not all of the cartilage is replaced by bone tissue. Some cartilage that performs a protective and supportive function...
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A Rat Tibial Growth Plate Injury Model to Characterize Repair Mechanisms and Evaluate Growth Plate Regeneration Strategies
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Predicting Growth Quantitatively Through Proximal Tibia Radiograph Markers.

Joseph B Kahan1, Don T Li1,2, Christopher A Schneble1

  • 1Departments of Orthopaedics and Rehabilitation.

Journal of Pediatric Orthopedics
|May 15, 2020
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Summary
This summary is machine-generated.

This study introduces three new radiographic measurements of the proximal tibia to accurately assess skeletal maturity. These measurements, when combined, provide a reliable method for predicting remaining growth in children and adolescents.

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Area of Science:

  • Orthopaedic surgery
  • Radiographic assessment
  • Skeletal maturity evaluation

Background:

  • Accurate skeletal maturity markers are crucial for managing pediatric orthopaedic conditions like scoliosis and leg length discrepancy.
  • Existing radiographic systems lack specific parameters for assessing proximal tibial growth.
  • This study addresses the need for quantitative methods to evaluate skeletal maturity in the proximal tibia.

Purpose of the Study:

  • To establish quantitative radiographic parameters within the proximal tibia for assessing skeletal maturity.
  • To develop a reliable method for predicting remaining growth using proximal tibial measurements.

Main Methods:

  • Serial radiographs and physical examinations of 94 children (ages 3-18) from the Bolton Brush collection were analyzed.
  • Measurements of tibial epiphysis width, tibial metaphysis width, and lateral tibial epiphysis height were correlated with remaining growth.
  • Regression models and inter/intraobserver reliability studies (intraclass correlation coefficient) were conducted.

Main Results:

  • Tibial epiphysis width, tibial metaphysis width, and lateral tibial epiphysis height showed strong correlations with remaining growth (R values 0.57-0.84).
  • Ratios derived from these measurements demonstrated high reliability (intraobserver ICC 0.92-0.94, interobserver ICC 0.80-0.94).
  • A combined multiple linear regression model achieved a predictive R value of 0.917, indicating high accuracy independent of sex.

Conclusions:

  • Three easily obtainable radiographic measurements of the proximal tibia, when used in ratios, reliably correlate with remaining growth.
  • This quantitative technique offers an improved, sex-independent method for assessing skeletal maturity from lower extremity radiographs.
  • The findings can inform management of various pediatric orthopaedic conditions requiring growth prediction.