Predictive factors for recurrence after lower limb deformity correction in hypophosphatemic rickets

Area of Science:

• Orthopedics
• Pediatric Endocrinology
• Surgical Research

Background:

• Severe lower limb deformities in hypophosphatemic rickets often require surgical intervention.
• High recurrence rates of deformities post-surgery necessitate identification of predictive factors.
• Limited studies exist on factors predicting deformity recurrence after surgical correction.

Purpose of the Study:

• To identify predictive factors for lower limb deformity recurrence post-surgical correction in hypophosphatemic rickets.
• To analyze the impact of identified predictors on deformity recurrence.
• To improve early recognition, intervention, and prevention of recurrent deformities.

Main Methods:

• Retrospective review of 16 patients (aged 5-20 years) who underwent corrective osteotomies.
• Collection of demographic, biochemical, and radiographic data.
• Univariable Cox proportional hazard analyses and Kaplan-Meier estimation for recurrence prediction.

Main Results:

• Age under 10 years at surgery was associated with a significantly higher risk of recurrence (HR 5.5, p=0.04).
• Gradual correction using hemiepiphysiodesis showed a higher recurrence rate (HR 7.0, p=0.03).
• Kaplan-Meier analysis confirmed a significant difference in recurrence between patients younger and older than 10 years (p=0.02).

Conclusions:

• Age less than 10 years at the time of surgery is a significant predictor of lower limb deformity recurrence in hypophosphatemic rickets.
• Gradual correction with hemiepiphysiodesis may be a contributing factor to recurrence.
• Identifying these predictors allows for targeted interventions to prevent recurrent deformities.