Transphyseal Hemiepiphysiodesis: Is it Truly Reversible?

Area of Science:

• Orthopedic Surgery
• Pediatric Orthopedics
• Skeletal Growth and Development

Background:

• Percutaneous epiphysiodesis using transphyseal screws (PETS) is used for angular knee deformities.
• Surgeons hesitate to use PETS in younger children due to concerns about reversibility.
• This study investigates the effectiveness and reversibility of PETS.

Purpose of the Study:

• To evaluate the effectiveness of PETS in correcting coronal plane knee deformities.
• To assess the reversibility of PETS by examining physis behavior after screw removal.
• To determine if bone growth resumes after PETS screw removal.

Main Methods:

• Prospective case series of 21 patients (8-13 years) with coronal plane knee deformity.
• Monitoring PETS efficacy and performing low-dose CT scans 6 months post-removal.
• Measuring lower limb length, mLDFA, and MPTA preoperatively and post-removal to assess growth and reversibility.

Main Results:

• Significant correction rates for genu valgum (3.46 mm/mo) and genu varum (1.78 mm/mo).
• No physeal bony bars detected 6 months after screw removal.
• Growth resumption observed in 12 of 24 physes; 1 showed rebound deformity, 1 overcorrection.

Conclusions:

• PETS is a highly effective, reproducible, and safe method for hemiepiphysiodesis.
• PETS demonstrates true reversibility in the juvenile and early adolescent pediatric population.
• This technique offers a reliable solution for correcting angular knee deformities in young patients.