Advances in growth plate modulation for lower extremity malalignment (knock knees and bow legs)

Abstract

The development of this surgical technique for growth plate manipulation for the treatment of angular deformities of knees has expanded the indications for surgical management and has a potential to decrease the incidence and the severity of complications.

The Efficacy and Complications of 2-Hole 3.5 mm Reconstruction Plates and 4 mm Noncanulated Cancellous Screws for Temporary Hemiepiphysiodesis Around the Knee

“…3 Persistent angular deformities of the knee during early childhood can lead to growth-plate damage. 4 Although there are some controversies, increasing evidence demonstrates that the risk of progression of the malaligned knees to osteoarthritis is high 1,4,5 ; however, the minimum of the varus or valgus that contributes to osteoarthritis is unknown. 4 Surgical management of angular deformities around the knee includes osteotomy and hemiepiphysiodesis.…”

“…4 Although there are some controversies, increasing evidence demonstrates that the risk of progression of the malaligned knees to osteoarthritis is high 1,4,5 ; however, the minimum of the varus or valgus that contributes to osteoarthritis is unknown. 4 Surgical management of angular deformities around the knee includes osteotomy and hemiepiphysiodesis. 6 Although osteotomy is considered the gold standard and definitive method of treatment in severe deformities, 2,4,6,7 it is a highly complicated procedure with inherent risks for compartment syndrome, neurovascular injuries, restricted weightbearing, joint stiffness, and delayed union and nonunion.…”

“…2, 13 Stevens 3,14 described the concept of guide growth by nonlocking 8-plate and 2 screws. Despite the established efficacy of Steven's method in many other series, [1][2][3][4]6,7,[12][13][14][15] higher cost of the 8-plate renders its use limited in developing countries. Because of the limited availability of the 8-plate in our country, the aim of this study was to evaluate the efficacy and complications of temporary hemiepiphysiodesis of the knee using 2-hole 3.5 mm stainless steel reconstruction plates and 4 mm solid (noncanulated) cancellous screws.…”

“…4 Surgical management of angular deformities around the knee includes osteotomy and hemiepiphysiodesis. 6 Although osteotomy is considered the gold standard and definitive method of treatment in severe deformities, 2,4,6,7 it is a highly complicated procedure with inherent risks for compartment syndrome, neurovascular injuries, restricted weightbearing, joint stiffness, and delayed union and nonunion. In children with open physis, more distal location of proximal tibial osteotomy has been associated with more anterior tibial arterial compromise.…”

Gait analysis and machine learning classification on healthy subjects in normal walking

“…However, most of the studies focus on the impaired gait of patients in relation to their disease or injury. For example, gait dynamics of the Parkinson's disease patients is extensively studied [1][2][3], and there are also many studies on the gait patterns with bowlegs and knock knees [4,5]. Though there are some studies on healthy human gait and many methodological improvements have been made [6][7][8][9], the body movement of walkers has not been extensively investigated and there is almost no study that tried to evaluate the functionality of heathy subjects in normal walking.…”