Abstract
Purpose
Coronal plane deformities around the knee are rather common condition in children. Guided growth by temporary hemiepiphysiodesis is considered to be the preferred primary treatment in many cases. Despite the popularity of hemiepiphysiodesis, the incidence of recurrence of deformity and predictors for rebound are not well defined.
The objectives of this study were to determine the incidence of the recurrence of varus–valgus deformities around the knee treated by temporary hemiepiphysiodesis and possible predictors for the rebound.
Methods
We retrospectively reviewed medical records and x-ray images of 130 patients with varus–valgus deformities around the knee treated by tension-band (eight-plate) hemiepiphysiodesis, between the years 2006 and 2016 in our institution. The incidence of rebound of varus–valgus deformities around the knee and possible predictors were analyzed.
Results
Rebound of the deformity was observed in 10% of patients. Risk factors found to be in correlation with recurrence include young age, deformity of proximal tibia, proximal tibial medial growth plate beaking, and comorbidities (like metabolic disorders, multiple hereditary exostoses and genetic syndromes).
Conclusion
The results of this study show that there is a noteworthy incidence of rebound in patients treated by temporary hemiepiphysiodesis for coronal deformities around the knee. The risk factors are also outlined. These patients, especially the ones with risk factors, require close surveillance until maturity.
Level of evidence
Level III—Case control study
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Data availability
The data is stored partially in a dedicated vault in our department as a hard copy and partially in an excel file that does not contain any identifiable information of the patients. All materials can be made available to reviewers upon request.
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The manuscript has been read and approved by all authors, and the requirements for authorship have been met (as stated by ICMJE), and each author believes that the manuscript represents honest work. MZ, MD—data collection, performed measurements, statistical analysis, manuscript preparation. PK, MD—study design, data collection, manuscript preparation. ME, MD—performed measurements, manuscript preparation.
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The authors have no relevant financial or non-financial interests to disclose.
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This retrospective chart review study involving human participants was in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The Human Investigation Committee (IRB) of The Rambam Health Care Campus approved this study.
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As this is a retrospective chart review, and no identifiable information appears in the processed and published data, the requirement for consent was waived by the IRB of The Rambam Health Care Campus.
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Zaidman, M., Kotlarsky, P. & Eidelman, M. Rebound predictors of varus–valgus deformities around the knee corrected by guided growth. Eur J Orthop Surg Traumatol 33, 837–842 (2023). https://doi.org/10.1007/s00590-022-03217-y
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DOI: https://doi.org/10.1007/s00590-022-03217-y