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Blount Disease and Obstructive Sleep Apnea: An Under-recognized Association?
Achraf Jardaly1,2, Gerald McGwin2,3, Shawn R Gilbert2
1Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon.
Journal of Pediatric Orthopedics
|May 21, 2020
Summary
Children with Blount disease have a high prevalence of obstructive sleep apnea (OSA), leading to increased surgical complications. Early diagnosis and preoperative planning are crucial for managing OSA in these patients.
Area of Science:
- Pediatric Orthopedics
- Sleep Medicine
- Anesthesiology
Background:
- Obesity is a significant risk factor for both Blount disease and obstructive sleep apnea (OSA).
- Obesity and OSA can increase anesthetic and postoperative complication risks in children.
- Children with Blount disease may have co-occurring OSA, necessitating perioperative risk assessment.
Purpose of the Study:
- To determine the prevalence of OSA in children undergoing surgery for Blount disease.
- To identify perioperative complications associated with Blount disease and OSA.
- To evaluate the impact of OSA on surgical outcomes in pediatric Blount disease patients.
Main Methods:
- Retrospective review of single-institution records and analysis of the Kids' Inpatient Database.
- Inclusion criteria: patients under 18 years old undergoing corrective surgery for Blount disease.
- Study design: Level III-case-control study.
Main Results:
- Institutional review found a 23% OSA prevalence in surgically treated Blount disease patients (all obese).
- National database (Kids' Inpatient Database) showed 3% OSA diagnosis in 1059 Blount disease cases.
- Overall, 4.4% of Blount children experienced complications, increasing hospitalization by 4.3 days and charges by 39%.
Conclusions:
- A low diagnosed OSA prevalence in national data may indicate underdiagnosis in children with Blount disease.
- Untreated OSA significantly increases surgical morbidity in pediatric Blount disease patients.
- Preoperative screening and planning are essential to mitigate OSA-related complications.
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