A Biomechanical Analysis of the Etiology of Tibia Vara

Sd, Cook; Cj, Lavernia; Sw, Burke; Hb, Skinner; Rj, Haddad

doi:10.1097/01241398-198309000-00006

Cited by 121 publications

(72 citation statements)

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“…The increased loads caused by the adduction moment on the knee during ambulation and physical activity could therefore lead to the development of varus alignment secondary to delayed growth on the medial side and accelerated growth on the lateral physes [14,18,42]. Cook et al [9] alluded to this theory in a biomechanical study on the etiology of pediatric tibia vara.…”

Section: Discussionmentioning

confidence: 99%

The Chitranjan Ranawat Award: Is Neutral Mechanical Alignment Normal for All Patients?: The Concept of Constitutional Varus

Bellemans¹,

Colyn

Vandenneucker

et al. 2012

Clinical Orthopaedics &Amp; Related Research

852

736

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Section: Discussionmentioning

confidence: 99%

The Chitranjan Ranawat Award: Is Neutral Mechanical Alignment Normal for All Patients?: The Concept of Constitutional Varus

Bellemans¹,

Colyn

Vandenneucker

et al. 2012

Clinical Orthopaedics &Amp; Related Research

852

736

View full text Add to dashboard Cite

show abstract

“…It may also be speculated that the more posteriorly located weightbearing axis in patients with flexion contractures can add to the increased posterior slope of the tibia by adding a compressive load to the posterior growth plate. This would result in growth retardation manner similar to that seen in other pathologic states, such as Blount's disease, where excessive mechanical loading results in varus angular deformities about the knee [5,6].…”

Section: Introductionmentioning

confidence: 99%

The effects of patellar tendon advancement on the immature proximal tibia

Patthanacharoenphon

Maples

Saad

et al. 2013

Journal of Children's Orthopaedics

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Purpose The aim of this study is to examine the shortterm effects of patellar tendon advancement on the proximal tibial slope in the skeletally immature patient. Methods A retrospective, non-randomized, comparative cohort design was used. Koshino indices and tibial slopes were assessed pre-operatively and post-operatively and compared with age-and sex-matched controls. Results Nine children with 17 patellar tendon advancements were analyzed for changes in Koshino indices. Of these 17 tibiae, radiographs on changes in tibial slope were available for 16 tibiae which were also compared with controls. Children aged \11 years had a greater initial posterior tibial slope (69.8°± 3.5°) than age-matched controls (80.3°± 2.7°). A decrease in posterior slope was seen in these younger patients (average change 10.3°± 4.8°) at an average of 1.6 years of follow-up. Of the nine apophyses in children aged \11 years of age, seven had undergone premature closure. ConclusionPatellar tendon advancement appears to have an unreported effect on the proximal tibial growth in the young patient (\11 years old). These patients appear to be susceptible to apophyseal closure, resulting in subsequent loss of posterior tibial slope. Surgeons should be aware of this effect and monitor younger patients with radiographs if performing this procedure.

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“…It is thought that progression of deformities such as scoliosis and tibia vara in growing children is caused at least in part by asymmetrical forces on the growth plates, creating differential growth and subsequent deformity [4,14,18]. Conservative management of these deformities by bracing is based on the premise that endochondral growth can be altered beneficially by modifying the mechanical forces acting on the growth plate.…”

Section: Introductionmentioning

confidence: 99%

Modulation of vertebral and tibial growth by compression loading: Diurnal versus full‐time loading

Stokes

Gwadera

Dimock

et al. 2005

Journal Orthopaedic Research

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Purpose: This study was designed to determine whether the amount of endochondral growth response to mechanical compression and the underlying growth mechanism differed with night-time or day-time loading, relative to full-time loading.Methods: Mechanical compression (nominally 0.1 MPa stress) was applied across tibial and tail vertebral growth plates of growing Sprague-Dawley rats. Four groups of animals (five per group) were used: 24/24 h (full-time loading); 12/24 h (day-loading); 12/ 24 h (night-loading); and 0124 h (sham instrumented). Contralateral tibiae and adjacent vertebrae served as within-animal controls. The animals were euthanized after eight days. Growth plates were processed for quantitative histology to measure 24-h growth, total and BrdU-positive proliferative zone chondrocyte counts, and hypertrophic chondrocytic enlargement in the growth direction.Results: Growth as a percentage of within-animal control averaged 82% (full-time); 93% (day-loading); 90% (night-loading); 100% (sham) for vertebrae. For proximal tibiae it averaged 70% (full-time); 84'% (day-loading); 86% (night-loading); 89% (sham). Reduced amount of hypertrophic chondrocytic enlargement explained about half of this effect in full-time loaded growth plates, but was not significantly altered in half-time loaded growth plates. The remaining variation in growth was apparently explained by reduced total numbers of proliferative zone chondrocytes. These findings indicate that sustained compression loading suppressed growth more than intermittent loading at both anatomical locations.

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A Biomechanical Analysis of the Etiology of Tibia Vara

Cited by 121 publications

References 0 publications

The Chitranjan Ranawat Award: Is Neutral Mechanical Alignment Normal for All Patients?: The Concept of Constitutional Varus

The Chitranjan Ranawat Award: Is Neutral Mechanical Alignment Normal for All Patients?: The Concept of Constitutional Varus

The effects of patellar tendon advancement on the immature proximal tibia

Modulation of vertebral and tibial growth by compression loading: Diurnal versus full‐time loading

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