Guided growth: indications and techniques for correction of knock knees and bowlegs

Tuca, María; Franz, Pia; Guerra, Daniela; Sepúlveda, Matías

doi:10.1097/mop.0000000000001094

Cited by 2 publications

(1 citation statement)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The deviation of this line in relation to the center of the knee (mechanical axis deviation) has a normal range between 0 AE 3 mm or even up to 17 mm medial [24,25]. A medial mechanical axis in small children can be related to a physiologic varus orientation of the distal femur in which a mechanical lateral distal femoral angle is above 908 and reaches the adult value by the age of 4 years.…”

Section: Imagingmentioning

confidence: 99%

Growth modulation for angular knee deformities: a practical guideline

Braga

Santili

Rodrigues

et al. 2022

Current Opinion in Pediatrics

View full text Add to dashboard Cite

Purpose of reviewThis study aimed to review the established concepts and advances related to growth modulation for treating knee angular deformities. Although they are considered well tolerated procedures, careful indications and accurate techniques are necessary to ensure good results.Recent findingsIn addition to general clinical and radiographic evaluations, new tools such as two-dimensional low-dose radiography and gait analysis have been used to clarify angular and torsional combinations and the impact of mild angulations on the knee joint. Temporary epiphysiodesis is commonly the choice, and it can be performed with different implants such as staples, tension band plates (TBP), percutaneous transphyseal screws (PETS), sutures, and screws.SummaryConsidering its principles, TBP has been preferred for younger children. Cost can be a limitation, and research for alternative implants such as screws and nonabsorbable sutures indicate they might be an alternative in the future. In adolescents, PETS becomes an attractive alternative; however, its reversible character has been controversial, and further studies are needed to establish limits in younger patients.

show abstract

Section: Imagingmentioning

confidence: 99%

Growth modulation for angular knee deformities: a practical guideline

Braga

Santili

Rodrigues

et al. 2022

Current Opinion in Pediatrics

View full text Add to dashboard Cite

show abstract

The causality between rheumatoid arthritis and postural deformities: bidirectional Mendelian randomization study and mediation analysis

Zhao,

Chen,

Wen

et al. 2024

Front. Immunol.

View full text Add to dashboard Cite

BackgroundTo better understand the preventive or therapeutic clinical interventions that may be supported by the association between rheumatoid arthritis (RA) and postural deformities including hallux valgus, flat foot, and scoliosis, this study was conducted using Mendelian randomization (MR) analysis. It aimed to investigate whether RA is causally associated with postural deformities in European populations.MethodsSummary-level data on RA and postural deformities were obtained from the IEU OpenGWAS project and Finngen database, respectively. LDSC regression analysis was conducted to assess the genetic correlation between these diseases. The inverse variance weighting (IVW) method was employed as the primary approach for two-sample MR analyses to evaluate causality. Supplementary methods included MR-Egger, maximum likelihood, weighted median, and cML-MA. To test for potential horizontal pleiotropy, we performed the MR-Egger intercept test, cML-MA, and secondary analyses after excluding confounders. Additionally, mediation analyses were conducted using two-step MR.ResultsThe IVW method revealed RA to be causally associated with hallux valgus (OR 1.132, 95% CI 1.087-1.178, P < 0.001) and flat foot (OR 1.197, 95% CI 1.110-1.291, P < 0.001). Among postural deformities, hallux valgus was causally associated with flat foot (OR 1.823, 95% CI 1.569-2.119, P < 0.001) and scoliosis (OR 1.150, 95% CI 1.027-1.287, P < 0.05). No significant horizontal pleiotropy was detected. Moreover, mediation analyses indicated that hallux valgus mediates the effect of RA on flat foot (mediation effect 0.024, 95% CI 0.005-0.044, P < 0.05), with a mediation proportion of 41.31%.ConclusionThese findings indicate a potential causal association between genetically predicted RA and both hallux valgus and flat foot. Furthermore, hallux valgus serves as a mediator in the pathway from RA to flat foot. This underscores the importance of early screening and preventive treatment of foot deformities in RA patients. Further research is necessary to determine the applicability of these findings in non-European populations.

show abstract

Guided growth: indications and techniques for correction of knock knees and bowlegs

Cited by 2 publications

References 34 publications

Growth modulation for angular knee deformities: a practical guideline

Growth modulation for angular knee deformities: a practical guideline

The causality between rheumatoid arthritis and postural deformities: bidirectional Mendelian randomization study and mediation analysis

Contact Info

Product

Resources

About