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Postoperative growth rate affects time to growth arrest after percutaneous physiodesis: A radiostereometric analysis

PURPOSE: The aim of this study was to determine the time at which physeal arrest is achieved after percutaneous physiodesis, and whether immediate postoperative growth rate affects the time to reach physeal arrest. METHODS: Radiostereometric analysis, with implantation of tantalum balls as radiograp...

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Autores principales: Wingstrand, Maria, Elfving, Maria, Hägglund, Gunnar, Lauge-Pedersen, Henrik
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9254027/
https://www.ncbi.nlm.nih.gov/pubmed/35800652
http://dx.doi.org/10.1177/18632521221105781
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author Wingstrand, Maria
Elfving, Maria
Hägglund, Gunnar
Lauge-Pedersen, Henrik
author_facet Wingstrand, Maria
Elfving, Maria
Hägglund, Gunnar
Lauge-Pedersen, Henrik
author_sort Wingstrand, Maria
collection PubMed
description PURPOSE: The aim of this study was to determine the time at which physeal arrest is achieved after percutaneous physiodesis, and whether immediate postoperative growth rate affects the time to reach physeal arrest. METHODS: Radiostereometric analysis, with implantation of tantalum balls as radiographic markers on each side of the physes, was used to measure residual longitudinal growth in 21 children (10 boys and 11 girls) after percutaneous physiodesis for leg length discrepancy or extreme tall stature. In total, 25 femoral and 20 tibial physes were operated on. Median age at surgery was 13.9 years (range = 11.4–16.1). Radiostereometric analysis was performed postoperatively and after 3, 6, 9, 12, 26, and 52 weeks. Longitudinal growth rate <50 µm per week was defined as physeal arrest. Descriptive statistics were used for evaluation. RESULTS: Physeal arrest was obtained in 19 of the 21 children (40 physes) within 12 weeks postoperatively. One child was reoperated on in three out of four physes because of continued growth, and in one child, delayed physeal arrest was present at 26 weeks postoperatively. Time to physeal arrest was longer in physes with a higher immediate postoperative growth rate. CONCLUSION: Postoperative follow-up with radiostereometric analysis at 12 and 15 weeks can determine whether physeal arrest has been achieved. The immediate postoperative growth rate after physiodesis seems to affect the time to physeal arrest. This implies that the risk for complications is greater for children during an accelerated growth period, for example, in boys, younger children and in distal femoral physes. LEVEL OF EVIDENCE: level III.
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spelling pubmed-92540272022-07-06 Postoperative growth rate affects time to growth arrest after percutaneous physiodesis: A radiostereometric analysis Wingstrand, Maria Elfving, Maria Hägglund, Gunnar Lauge-Pedersen, Henrik J Child Orthop Deformity and limb deficiency PURPOSE: The aim of this study was to determine the time at which physeal arrest is achieved after percutaneous physiodesis, and whether immediate postoperative growth rate affects the time to reach physeal arrest. METHODS: Radiostereometric analysis, with implantation of tantalum balls as radiographic markers on each side of the physes, was used to measure residual longitudinal growth in 21 children (10 boys and 11 girls) after percutaneous physiodesis for leg length discrepancy or extreme tall stature. In total, 25 femoral and 20 tibial physes were operated on. Median age at surgery was 13.9 years (range = 11.4–16.1). Radiostereometric analysis was performed postoperatively and after 3, 6, 9, 12, 26, and 52 weeks. Longitudinal growth rate <50 µm per week was defined as physeal arrest. Descriptive statistics were used for evaluation. RESULTS: Physeal arrest was obtained in 19 of the 21 children (40 physes) within 12 weeks postoperatively. One child was reoperated on in three out of four physes because of continued growth, and in one child, delayed physeal arrest was present at 26 weeks postoperatively. Time to physeal arrest was longer in physes with a higher immediate postoperative growth rate. CONCLUSION: Postoperative follow-up with radiostereometric analysis at 12 and 15 weeks can determine whether physeal arrest has been achieved. The immediate postoperative growth rate after physiodesis seems to affect the time to physeal arrest. This implies that the risk for complications is greater for children during an accelerated growth period, for example, in boys, younger children and in distal femoral physes. LEVEL OF EVIDENCE: level III. SAGE Publications 2022-06-30 2022-06 /pmc/articles/PMC9254027/ /pubmed/35800652 http://dx.doi.org/10.1177/18632521221105781 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Deformity and limb deficiency
Wingstrand, Maria
Elfving, Maria
Hägglund, Gunnar
Lauge-Pedersen, Henrik
Postoperative growth rate affects time to growth arrest after percutaneous physiodesis: A radiostereometric analysis
title Postoperative growth rate affects time to growth arrest after percutaneous physiodesis: A radiostereometric analysis
title_full Postoperative growth rate affects time to growth arrest after percutaneous physiodesis: A radiostereometric analysis
title_fullStr Postoperative growth rate affects time to growth arrest after percutaneous physiodesis: A radiostereometric analysis
title_full_unstemmed Postoperative growth rate affects time to growth arrest after percutaneous physiodesis: A radiostereometric analysis
title_short Postoperative growth rate affects time to growth arrest after percutaneous physiodesis: A radiostereometric analysis
title_sort postoperative growth rate affects time to growth arrest after percutaneous physiodesis: a radiostereometric analysis
topic Deformity and limb deficiency
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9254027/
https://www.ncbi.nlm.nih.gov/pubmed/35800652
http://dx.doi.org/10.1177/18632521221105781
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