Efficacy and Safety of Percutaneous Epiphysiodesis Operation around the Knee to Reduce Adult Height in Extremely Tall Adolescent Girls and Boys

Abstract

Objective. The aim was to determine efficacy and safety of a surgical method to reduce adult height in extremely tall adolescents. Methods. Data for all girls (n = 12) and boys (n = 9) in our center subjected to bilateral percutaneous epiphysiodesis around the knee who had reached final height were included. Final height predictions were based on hand and wrist X-rays before surgery. Results. When compared to prediction, adult height was reduced by 4.1 ± 0.7 cm in treated girls (P < .001) and 6.4 ± 0.7 cm in treated boys (P < .001) corresponding to a 33.6 ± 3.4% and 33.6 ± 4.2% reduction of remaining growth, respectively. Besides mild to moderate postoperative pain reported in 9 operated individuals, no other side effects were reported. Postoperative X-rays confirmed growth plate closure and absence of leg angulations. Conclusions. Bilateral epiphysiodesis is an effective and safe method to reduce adult height in extremely tall girls and boys.

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

“…There are two smaller studies on treatment effect of PE, showing similar results. Benyi et al 2 reported a mean reduction of 4.1±0.7 cm in 12 girls and 6.4±0.7 cm in 9 boys. Odink et al 1 reported a mean reduction of 7.0 cm (range 1.2–13.8 cm) in 15 tall boys.…”

Evaluation and phenotypic characteristics of 293 Danish girls with tall stature: effects of oral administration of natural 17β-estradiol

“…There are alternatives to pharmacological treatment for CTS. Benyi et al (14) reported a height reduction, compared to prediction, of 4.1 cm in 12 girls subjected to bilateral percutaneous epiphysiodesis. No side effects except postoperative pain were reported.…”

“…EE2 treatment of extreme tall stature has become increasingly debated and controversial. In Sweden, percutaneous epiphysiodesis operation is suggested as an alternative to EE2 treatment (14). In our center, we introduced an alternative clinical practise 20 y ago, when we introduced early treatment with oral administration of natural estrogens (17β-estradiol (E2)).…”

Investigation and management of tall stature

“…Others have recommended that the intervention should be performed at a bone age not exceeding 12.5 years in girls and 14 years in boys, and that a treatment decision should be taken before girls have reached a height of 170 cm and boys 185 cm. A potential side-effect is the development of leg length discrepancy although in a recent series this was not observed 21. This intervention remains controversial and further data on its safety profile are required.…”