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Functional Assessment of Patients With Valgus or Varus Knee Deformity After Distal Femoral and Proximal Tibial
Paweł Leyko1, Łukasz Tomczyk2, Piotr Morasiewicz1
1Department of Orthopaedic and Trauma Surgery, Institute of Medical Sciences, University of Opole, Opole.
Background:
One method of treating knee joint deformities in children is hemiepiphysiodesis. The post-treatment functioning and physical activity levels of patients after hemiepiphysiodesis have not been fully explored. The aim of our study was to assess functional outcomes of hemiepiphysiodesis of the distal femur and proximal tibia performed due to valgus or varus knee deformity.
Methods:
In this prospective study, we assessed 36 patients with valgus or varus knee deformity treated with hemiepiphysiodesis of the distal femur and proximal tibia. We assessed the following parameters: pain severity, the level-of physical activity [in a visual analog scale (VAS), Grimby scale, and the University of California, Los Angeles (UCLA) scale], the use of analgesics, the willingness to choose the same treatment method again, the level-of satisfaction with treatment, and the rate of complications.
Results:
The mean follow-up period was 24 months. All the patients would choose the same treatment method again. Thirty-five patients (97%) were very satisfied with treatment. The median VAS score for physical activity was 7 preoperatively and at long-term follow-up. The median level of activity, assessed with the Grimby scale, was 5 before treatment and 5 after treatment. The median level of activity, as rated on the UCLA scale, was 7 before treatment and at follow-up. The median VAS-rated pain intensity was 0 before treatment and decreased significantly after treatment (median 0), P=0.032. The proportion of patients who used analgesics before surgery was 14%, and none used them after treatment. Three patients (8%) developed complications.
Conclusions:
Hemiepiphysiodesis does not affect physical activity levels. After their treatment, all patients reported being satisfied or very satisfied. Valgus or varus knee deformity correction helps reduce pain and yields good functional outcomes.
Level Of Evidence:
Level IV-case series.
