What is the clinical evidence from this study?

Study design: Observational. Population: Legg-Calvé-Perthes disease (lateral pillar B and B/C border) (n=19). Intervention: Age 8 years at time of GTE after FVO. Primary outcome: Amount of correction of the articulotrochanteric distance (ATD) in the affected hip (p=0.001).

August 1, 2017MedicineOpen Access

Effect of greater trochanteric epiphysiodesis after femoral varus osteotomy for lateral pillar classification B and B/C border Legg–Calvé–Perthes disease

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Key result

Greater trochanteric epiphysiodesis after femoral varus osteotomy in patients under 8 years of age with Legg-Calvé-Perthes disease significantly improved articulotrochanteric distance correction compared to patients over 8 years of age (6.9 vs -3.3 cm, p=0.001).

Why the study?

Does greater trochanteric epiphysiodesis after femoral varus osteotomy inhibit trochanteric growth in children with lateral pillar B and B/C border LCPD?

Population

19 male children with unilateral lateral pillar B and B/C border Legg-Calvé-Perthes disease who underwent…

Comparison

Greater trochanteric epiphysiodesis performed… vs The contralateral, unaffected hip was used as a…

Design

Cohort, Radiographic measurements were assessed by 3 orthopedic surgeons…

Follow-up

Until skeletal maturity

Authors

KKKeun-Sang KwonChonbuk National University Hospital SWSung Il WangChonbuk National University Hospital JLJu-Hyung LeeTa Solutions (China)

Discussion

Member takes

Implication

Suggests age-targeted surgical timing may optimize hip mechanics in Legg-Calvé-.

Study Design

Type

Observational (n=19)

Multicenter

Structured PICO

Does greater trochanteric epiphysiodesis after femoral varus osteotomy inhibit trochanteric growth in children with lateral pillar B and B/C border LCPD?

Population

19 male children with unilateral lateral pillar B and B/C border Legg-Calvé-Perthes disease who underwent femoral varus osteotomy followed by greater trochanteric epiphysiodesis, followed to skeletal maturity.

Exposure

Greater trochanteric epiphysiodesis (GTE) performed after femoral varus osteotomy (FVO) in patients <8 years old (n=9) vs >8 years old (n=10).

Comparator

The contralateral, unaffected hip was used as a control for trochanteric growth. Comparisons were also made between the two age groups (<8 years vs >8 years).

Outcome

Trochanteric growth inhibition measured by articulo-trochanteric distance (ATD), center-trochanteric distance (CTD), and neck-shaft angle (NSA) at skeletal maturity.surrogate

Main Result

Absolute Event Rate: 6.9% vs -3.3%

p-value: p=0.001

Greater trochanteric epiphysiodesis after femoral varus osteotomy effectively inhibits trochanteric growth in children with LCPD under 8 years of age, but not in those over 8 years.

Limitations

Retrospective design
Small number of cases
Adjusted analysis could not be performed
No comparison to patients treated with FVO alone
Could not compare results between patients with lateral pillar B and B/C border
Did not compare results to patients treated with FVO alone
Could not compare results between patients with lateral pillar B and B/C border due to small sample size

Cite This Study

Kwon et al. (2017) conducted an observational in Legg-Calvé-Perthes disease (lateral pillar B and B/C border) (n=19). Age <8 years at time of greater trochanteric epiphysiodesis (GTE) after femoral varus osteotomy (FVO) vs. Age >8 years at time of GTE after FVO was evaluated on Amount of correction of the articulotrochanteric distance (ATD) in the affected hip (p=0.001). Greater trochanteric epiphysiodesis after femoral varus osteotomy in patients under 8 years of age with Legg-Calvé-Perthes disease significantly improved articulotrochanteric distance correction compared to patients over 8 years of age (6.9 vs -3.3 cm, p=0.001).

synapsesocial.com/papers/6a8854f1be6952a959583cbf https://doi.org/10.1097/md.0000000000007723

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Effect of greater trochanteric epiphysiodesis after femoral varus osteotomy for lateral pillar classification B and B/C border Legg–Calvé–Perthes disease

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Effect of greater trochanteric epiphysiodesis after femoral varus osteotomy for lateral pillar classification B and B/C border Legg–Calvé–Perthes disease

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Also Consider