Guided Growth for Idiopathic Coronal Plane Deformity around the Knee - The 36th Annual Meeting of the Israel Orthopaedic Association 2016, November 30-2 December, 2016, David InterContinental, Tel Aviv, Israel

author.DisplayName ¹ author.DisplayName ² author.DisplayName ³ author.DisplayName ³ author.DisplayName ⁴ author.DisplayName ⁵ author.DisplayName ¹ author.DisplayName ¹

¹Pediatric Orthopedic Department, Dana Children's Hospital, Tel-Aviv Sourasky Medical Center, Israel
²Klinik und Poliklinik für Allgemeine Orthopädie und Tumororthopädie, Universitätsklinikum Münster, Germany
³International Center for Limb Lengthening, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, USA
⁴Pediatric Orthopedic Department, Orthopedic Hospital Speising Vienna, Austria
⁵Pediatric Orthopedic Department, Sickkids Hospital Toronto, Canada

Background: The purpose of this study was to measure the effect of temporary hemiepiphysiodesis and to further define parameters that influence success in patients with idiopathic etiology.

Methods: Retrospective multicenter study including data on 372 physes in 206 patients, with an average follow-up of 16 months after plate insertion. Alignment analysis was compared preoperatively and in at least 2 measurements postoperatively; rate of correction (ROC) was calculated, univariate and multivariate analysis was performed to determine parameters that influence rate and amount of correction.

Results: Average age at plate implantation was 12.56 years (2.5-19.33, +/-2.34).

Of the deformities, 82% were valgus deformities.

Of the femoral physes 92% finished the treatment and of those, 93% achieved standard alignment (mLDFA 85-89 degrees); 2% of the patients had not reached standard alignment while 5% were over-corrected.

Of the tibial physes, 93% finished the treatment; of these, 92% achieved standard alignment (mMPTA 85-89 degrees); 2% of the patients had not achieved standard alignment while 6% were over-corrected.

8% of the femoral and 7% of the tibial physes have not yet achieved correction and are still growing.

ROC was significantly influence by age at plate implantation, type, location and extent of deformity.

ROC of the femur was significantly faster than the tibia: 0.85 compared to 0.78 degrees/month respectively (p=0.05).
ROC in valgus deformity of the femur was significantly faster than in varus deformity: 0.90 compared to 0.77 degrees/month respectively (p=0.04).
Patients with more than 38 remaining months to grow (12-59.33, +/-20.24), had a better chance to achieve full correction for both femur and tibia (p=0.119, 0.022 respectively).

Complications included 1% of early postoperative infection and 1% of early limited range of motion, but no screw breakage was recorded.

Conclusion: Success and ROC in the idiopathic group are high, with low rate of complications in coronal plane deformity around the knee. ROC in the femur is faster than the tibia; valgus femoral deformities are corrected faster than varus`.