Introduction
Materials and methods
Results
Parameters | Staple group | Eight plate group | Remarks |
---|---|---|---|
1. Age distribution (years) | Mean = 7.3 (range: 3.5–12) | Mean = 7.8 (range: 4–12) |
p-value = 0.53 (NS) |
2. Sex distribution | Male = 8 | Male = 8 |
p-value = 1 (NS) |
Female = 10 | Female = 11 | ||
3. Varus/valgus deformity | Varus = 8 knee joints | Varus = 4 knee joints |
p-value = 0.33 (NS) |
Valgus = 24 knee joints | Valgus = 27 knee joints | ||
4. Etiology | Skeletal dysplasia = 2 | Skeletal dysplasia = 2 | |
Idiopathic genu valgum = 20 | Idiopathic genu valgum = 18 | ||
Post-rachitic genu valgum = 4 | Post-rachitic genu valgum = 7 | ||
Post-rachitic genu varum = 6 | Post-rachitic genu varum = 2 | ||
Associated with congenital deformity = 2 | |||
5. Bilateral vs. unilateral | Bilateral = 14 patients | Bilateral = 12 patients |
p-value = 0.48 (NS) |
Unilateral = 4 patients | Unilateral = 7 patients | ||
6. Femoral and tibial components involvement | Femur = 32 | Femur = 31 |
p-value = 0.36 (NS) |
Tibia = 8 | Tibia = 4 |
Parameters | Staple group | Eight plate group | Remarks |
---|---|---|---|
Correction rate of mechanical lateral distal femoral angle (° per month) | 1.0° per month (SD = 0.35) | 1.3° per month (SD = 0.16) |
p-value = 0.004 (SIG) |
Range: 0.75–1.25 | Range: 0.81–2.25 | ||
Correction rate of mechanical medial proximal tibial angle (° per month) | 0.9° per month (SD = 0.10) | 0.8° per month (SD = 0.29) |
p-value = 0.001 (SIG) |
Range: 0.75–1.11 | Range: 0.56–1.12 | ||
Correction rate of anatomical tibio-femoral angle (° per month) | 1.2° per month (SD = 0.37) | 1.4° per month (SD = 0.30) |
p-value = 0.71 (NS) |
Range: 0.75–2.33 | Range: 1–2 | ||
Etiology-wise correction rate (° per month) | Skeletal dysplasia = 1.1° (n = 2) | Skeletal dysplasia = 1.0° (n = 2) |
p-value = 0.31 (NS) |
Idiopathic genu valgum = 1.0° (n = 18) | Idiopathic Genu valgum = 1.3° (n = 18) |
p-value = 0.0001 (SIG) | |
Post rachitic genu valgum = 1.1° (n = 4) | Post rickets genu valgum = 1.4° (n = 7) |
p-value = 0.14 (NS) | |
Post rachitic genu varum = 1.9° (n = 6) | Post rachitic genu varum = 1.9° (n = 2) |
p-value = 0.83 (NS) | |
Time of implant removal | Mean = 12 months | Mean = 10.3 months |
p-value = 0.54 (NS) |
Complication | Staple group | Eight plate group | Remarks |
---|---|---|---|
Wound healing-related complications | NIL | NIL |
p-value = 1.0 (NS) |
No correction in first 4 months | NIL | NIL | All joints studied have measurable correction after 4 months |
p-value = 1.0 (NS) | |||
Physeal penetration | NIL | NIL |
p-value = 1.0 (NS) |
Implant migration/extrusion | Two knee joints (6.25 %) | NIL |
p-value = 0.49 (NS) |
Implant breakage | NIL | NIL |
p-value = 1.0 (NS) |
Failure of correction after 2 years | Two knee joints (6.3 %) both belonging to skeletal dysplasia (abnormal physes) | Two knee joints (6.5 %) both belonging to skeletal dysplasia (abnormal physes) |
p-value = 1.0 (NS) |
Requirement of additional procedure (osteotomy) | Four knee joints (12.5 %) | Two knee joints (6.5 %) |
p-value = 0.43 (NS) |
Overcorrection more than 5° | NIL | NIL |
p-value = 1.0 (NS) |
Recurrence | NIL | NIL |
p-value = 1.0 (NS) |
Limb length discrepancy more than 1 cm | Three cases, all unilateral (two idiopathic and one post-rickets genu valgum) | Two cases, both unilateral (both belonged to idiopathic genu valgum) |
p-value = 1.0 (NS) |
Total | 7 (22 %) | 4 (13 %) |
p-value = 0.51 (NS) |
Discussion
Wiemann et al. [15] | Jelinek et al. [14] | Gottliebsen et al. [16] | Our study | |
---|---|---|---|---|
Number of knee joints studied | Staple = 39 | Staple = 32 | Staple = 10 | Staple = 32 |
Eight plate = 24 | Eight plate = 33 | Eight plate = 10 | Eight plate = 31 | |
Age distribution (in years) | Staple group = 12.6 (range: 8.5–16.7) | Staple group = 11.6 (range: 2.9–16) | Staple group = 11.1 (range: 6–13) | Staple group = 7.3 (range: 3.5–12) |
Eight plate group = 11.1 (range: 5.2–16) | Eight plate group = 13 (range: 10.5–15.2) | Eight plate group = 10.1 (range: 8–14) | Eight plate group = 7.8 (range: 4–12) | |
p = 0.04 (NS) |
p = 0.053 (NS) |
p > 0.05 (SIG) |
p = 0.53 (NS) | |
Male:female ratio | Staple group = 24:15 | Staple group = 11:7 | Staple group = 3:7 | Staple group = 8:10 |
Eight plate group = 11:13 | Eight plate group = 8:9 | Eight plate group = 8:2 | Eight plate group = 8:11 | |
p = 0.298 (NS) |
p = 0.50 (NS) |
p < 0.05 (SIG) |
p = 1 (NS) | |
Abnormal physes | Staple = 11 | Staple = 5 | NIL | Staple = 2 |
Eight plate = 7 | Eight plate = 4 | Eight plate = 2 | ||
p = 1.0 (NS) |
p = 1.0 (NS) |
p = 1.0 (NS) | ||
Mean correction rate (° per month) | mLDFA = NA mMPTA = NA TFA = 0.825° for staples, 0.925° for eight plate
p = 0.489 (NS) | mLDFA = 1° (range: 0–2) for both staples and eight plate
p = 0.35 (NS) | mLDFA = NA mMPTA = NA TFA = NA | mLDFA = 1.0° (range: 0.75–1.25) for staples and 1.3° (range: 0.81–2.25) for eight plate
p = 0.004 (SIG) |
mMPTA = 1° (range: 0–2) for both staples and eight plate
p = 0.56 (NS) | mMPTA = 0.9° (range: 0.75–1.11) for staples and 0.8° (range: 0.56–1.12) for eight plate
p = 0.001 (SIG) | |||
TFA = NA | TFA = 1.2° (range: 0.75–2.33) for staples and 1.4° (range: 1–2) for eight plate
p = 0.70 (NS) | |||
Mean time of implant removal | NA | Eight plate 11.9 ± 6.8 months (range: 1.9–27.9 months) | Eight plate 11.33 months (range: 9.5–13.1 months) | Eight plate 10.31 months |
Staple 11.0 ± 6.2 months (range: 4.5–28.1 months) | Staple 11.63 months (range: 8.76–14.5 months) | Staple 12.03 months | ||
p = 0.555 (NS) |
p = 0.8 (NS) |
p = 0.543 (NS) | ||
Complications | Eight plate: Screw breakage = 1 Failure to correct = 3 | Eight plate: Overcorrection = 4 | Eight plate: Rebound growth = 1 | Eight plate: Failure = 2 Limb length discrepancy >1 cm = 2 |
Staples: Implant migration = 1 Failure to correct = 2 Overcorrection = 3 | Staples: Post-operative wound site infection = 1 Implant migration = 2 | Staples: None | Staples Failure = 2 Limb length discrepancy >1 cm = 3 Implant migration = 2 | |
p = 1.0 (NS) Limb length discrepancy = NA |
p > 0.005 (NS) Failure to correct = NA |
p = 0.51 (NS) |