Long-term follow-up after bilateral percutaneous epiphysiodesis around the knee to reduce excessive predicted final height

• Published in: Archives of disease in childhood Vol. 103; no. 3; pp. 219 - 223
• Main Authors: Goedegebuure, Wesley J, Jonkers, Frank, Boot, Annemieke M, Bakker-van Waarde, Willie M, van Tellingen, Vera, Heeg, Minne, Odink, Roelof J, van Douveren, Florens, Besselaar, Arnold T, van der Steen, Marieke C
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01-03-2018
• Subjects: Acne; Adolescent; Adolescents; Body height; Body Height - physiology; Child; Children; Children & youth; Epiphyses - growth & development; Epiphyses - surgery; Female; Females; Fibula; Follow-Up Studies; Girls; Growth Disorders - chemically induced; Growth Disorders - surgery; Height; Hormone Replacement Therapy - adverse effects; Humans; Knee; Male; Males; Orthopedic Procedures - methods; Patient satisfaction; Patient Satisfaction - statistics & numerical data; Patients; Personality Traits; Physical growth; Psychological aspects; Questionnaires; Retrospective Studies; Statistical Analysis; Surgery; Time Factors; Treatment Outcome; Women; X-rays; patient satisfaction; excessive tall stature; complications; efficacy
• ISSN: 0003-9888; 1468-2044
• DOI: 10.1136/archdischild-2017-313295

ContextPercutaneous epiphysiodesis (PE) around the knee to reduce predicted excessive final height. Studies until now included small numbers of patients and short follow-up periods.Objective and designThis Dutch multicentre, long-term, retrospective, follow-up study aimed to assess adult height (AH), complications, knee function and patient satisfaction after PE. The primary hypothesis was that PE around the knee in constitutionally tall boys and girls is an effective treatment for reducing final height with low complication rates and a high level of patient satisfaction.Participants77 treated adolescents and 60 comparisons.InterventionPercutaneous epiphysiodesis.OutcomeAH, complications, knee function, satisfaction.ResultsIn the PE-treated group, final height was 7.0 cm (±6.3 cm) lower than predicted in boys and 5.9 cm (±3.7 cm) lower than predicted in girls. Short-term complications in file search were seen in 5.1% (three infections, one temporary nerve injury), one requiring reoperation. Long-term complications in file search were seen in 2.6% (axis deformity 1.3%, prominent head of fibula 1.3%). No significant difference in knee function was found between treated cases and comparisons. Satisfaction was high in both the comparison and PE groups; most patients in the PE group recommended PE as the treatment for close relatives with tall stature.ConclusionPE is safe and effective in children with predicted excessive AH. There was no difference in patient satisfaction between the PE and comparison group. Careful and detailed counselling is needed before embarking on treatment.