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Long-term follow-up after bilateral percutaneous epiphysiodesis around the knee to reduce excessive predicted final height
  1. Wesley J Goedegebuure1,
  2. Frank Jonkers2,
  3. Annemieke M Boot3,
  4. Willie M Bakker-van Waarde3,
  5. Vera van Tellingen1,
  6. Minne Heeg4,
  7. Roelof J Odink1,5,
  8. Florens van Douveren2,
  9. Arnold T Besselaar2,6,
  10. Marieke C van der Steen6
  1. 1 Department of Pediatrics, Catharina Hospital, Eindhoven, The Netherlands
  2. 2 Orthopaedic Centre Máxima, Máxima Medical Centre, Eindhoven, The Netherlands
  3. 3 Department of Pediatric Endocrinology, University Medical Centre, University of Groningen, Groningen, The Netherlands
  4. 4 Department of Orthopaedic Surgery, Wilhelmina Hospital, Assen, The Netherlands
  5. 5 Department of Pediatrics, Máxima Medical Centre, Eindhoven, The Netherlands
  6. 6 Department of Orthopaedic Surgery, Catharina Hospital, Eindhoven, The Netherlands
  1. Correspondence to Wesley J Goedegebuure, Department of Paediatrics, Sub Division of Endocrinology Erasmus University Medical Centre, Rotterdam 3015 GJ, The Netherlands; w.goedegebuure{at}erasmusmc.nl

Abstract

Context Percutaneous epiphysiodesis (PE) around the knee to reduce predicted excessive final height. Studies until now included small numbers of patients and short follow-up periods.

Objective and design This Dutch multicentre, long-term, retrospective, follow-up study aimed to assess adult height (AH), complications, knee function and patient satisfaction after PE. The primary hypothesis was that PE around the knee in constitutionally tall boys and girls is an effective treatment for reducing final height with low complication rates and a high level of patient satisfaction.

Participants 77 treated adolescents and 60 comparisons.

Intervention Percutaneous epiphysiodesis.

Outcome AH, complications, knee function, satisfaction.

Results In the PE-treated group, final height was 7.0 cm (±6.3 cm) lower than predicted in boys and 5.9 cm (±3.7 cm) lower than predicted in girls. Short-term complications in file search were seen in 5.1% (three infections, one temporary nerve injury), one requiring reoperation. Long-term complications in file search were seen in 2.6% (axis deformity 1.3%, prominent head of fibula 1.3%). No significant difference in knee function was found between treated cases and comparisons. Satisfaction was high in both the comparison and PE groups; most patients in the PE group recommended PE as the treatment for close relatives with tall stature.

Conclusion PE is safe and effective in children with predicted excessive AH. There was no difference in patient satisfaction between the PE and comparison group. Careful and detailed counselling is needed before embarking on treatment.

  • excessive tall stature
  • efficacy
  • complications
  • patient satisfaction

https://doi.org/10.1136/archdischild-2017-313295

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    Footnotes

    • Contributors Conceptualisation of the work: WJG, FJ, RJO, MCS. Writing of original draft: WJG. Supervision: RJO, MCS. Formal analysis: WJG, FJ, MCS. Acquisition of the data: WJG, FJ, AMB, WMB, VVT, MH, FVD, ATB, RJO. Interpretation of the analysis: WJG, FJ, AMB, WMB-vW, VVT, RJO, MCS. Drafting the work: WJG, FJ, RJO, MCS. Revising the work: WJG, FJ, AMB, WMB-vW, VVT, MH, FVD, ATB, RJO, MCS. Final approval of the version to be published: WJG, FJ, AMB, WMB-vW, VVT, MH, FVD, ATB, RJO, MCS. Accountability for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved: WJG, FJ, AMB, WMB-vW, VVT, MH, FVD, ATB, RJO, MCS.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Ethics approval This study was approved by the medical ethical research board in Eindhoven for the Catharina Hospital (CH) (W16.010) and the Maxima Medical Centre (MMC) (N16.070), as well as data of the University Medical Centre Groningen (UMCG) (M16.189545).

    • Provenance and peer review Not commissioned; externally peer reviewed.

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