Intra-Articular Influence of PETS Technique Treating Limb Length Discrepancy for Both Femur and Tibia

Area of Science:

• Orthopedic surgery
• Pediatric orthopedics
• Radiology

Background:

• Volcano deformity, an intra-articular issue, has been linked to tension band plate (TBP) use.
• The potential for percutaneous epiphysiodesis using transphyseal screws (PETS) to cause intra-articular changes remains under investigation.

Purpose of the Study:

• To evaluate the potential for percutaneous epiphysiodesis using transphyseal screws (PETS) to induce central intra-articular deformity in the distal femur and proximal tibia.

Main Methods:

• Retrospective review of 42 patients undergoing bilateral distal femur and proximal tibia PETS with at least 1-year follow-up.
• Quantitative analysis of immediate postoperative and final follow-up radiographs.
• Assessment of intercondylar distance, intercondylar notch depth (femur), and intercondylar eminence height (tibia), along with limb alignment.

Main Results:

• Operated limbs showed a significant decrease in intercondylar distance (mean change: -1.92 mm, P<0.001).
• Significant changes in the operated femur and tibia included decreased intercondylar notch depth (-1.47 mm, P<0.001) and increased intercondylar eminence height (0.85 mm, P<0.001).
• Non-operated limbs exhibited no statistically significant changes in these parameters.

Conclusions:

• Percutaneous epiphysiodesis using transphyseal screws (PETS) may lead to intra-articular deformity in both the femur and tibia.
• The clinical significance of these radiologic changes requires further investigation.
• Additional research is necessary to fully understand the nature of PETS-induced intra-articular changes.