Objective: This retrospective study evaluated treatment with individually contoured molded bracing at early stages of the disease. Methods: We evaluated the medical records of patients undergoing treatment of Blount's disease with molded orthoses for medial decompression between 2010 and 2014. The deformity angle (Drennan's metaphyseal-diaphyseal angle) and Langenskiöld classification were measured before and after treatment by a pediatric orthopedic surgeon with over 5 years of practice, blinded for the study and patients. Results: The mean age was 2.57 years old. Four patients were female and six male. Half of the total sample had bilateral disease. The average deformity angle showed a statistically significant reduction after treatment (p <0.001). Gender and laterality did not statistically influence the change of the deformity angle after treatment (p> 0.05). Conclusion: The nightly use of molded orthoses for medial decompression was effective in reducing the metaphyseal-diaphyseal angle in Blount's disease in children under 3 years of age, regardless of gender and bilateral disease. Patients over 3 years old did not benefit from bracing. Level of Evidence IV, Case Series.

Two-portal knee arthroscopic synovectomy was effective at reducing bleeding recurrence and improving knee function and QOL in patients with haemophilia, but did not interrupt the progression of radiographic changes.

These results suggest that inlet radiographs may be a reliable method of assessing the reduction of the hip after the surgical treatment of DDH. Cite this article: 2017;99-B:697-701.

Objective: The purpose of our study is to evaluate intraobserver and interobserver reliability of modified Waldenström classification system for Legg-Calvé-Perthes disease and assess the influence of the professional’s area of expertise in the assessment. Methods: Twelve evaluators assessed 40 pairs of pelvic radiographs of patients with Legg-Calvé-Perthes disease. After two weeks, a new evaluation was performed by the same evaluators. Kappa and Kendall’s W indexes were used to evaluate both intraobserver and interobserver reliability and determine the influence of the evaluators’ experience and area of expertise. Results: The average intraobserver kappa value was 0.394, with a reasonable agreement level. The interobserver Kappa value was 0.243 in the first evaluation (95% CI, 0.227-0.259 and p < 0.0001) and 0.245 in the second evaluation (95% CI, 0.229-0.260 and p < 0.0001). The Kendall’s W values obtained for pediatric orthopedists, radiologists and resident physicians were 0.686, 0.630 and 0.529 (p < 0.0001), respectively. Conclusion: The modified Waldenström classification presented both moderate and reasonable levels of intraobserver agreement, and reasonable level of interobserver agreement. The evaluators’ degree of experience and area of expertise influenced the concordance level found. Level of Evidence II, Diagnostic Studies - Investigating a Diagnostic Test.

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