Modification of the alignment between the tibial tubercle and the trochlear groove induced by temporary hemiepiphysiodesis for lower extremity angular deformities: a trigonometric analysis

Ceroni, Dimitri; Dhouib, Amira; Merlini, Laura; Καμπούρογλου, Γεώργιος

doi:10.1097/bpb.0000000000000409

Cited by 8 publications

(4 citation statements)

References 9 publications

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“…Ceroni et al proposed a trigonometric formula for predicting the correction of TT-TG distance after guided growth correction of valgus using hemiepiphysiodesis. They indicated that a 1 mm change in TT-TG distance would be expected for every varus or valgus correction degree [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

TT-TG distance decreases after open wedge distal femoral varization osteotomy in patients with genu valgum & patellar instability. A pilot 3D computed tomography simulation study

Gür,

Yapici,

Subaşi

et al. 2023

BMC Musculoskelet Disord

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Background Genu valgum is considered to be a risk factor for patellar instability. Correction of valgus alone or combined with a tibial tuberosity medialization has been described. However, changes occurring in the tibial tuberosity-trochlear groove (TT-TG) distance after a lateral distal femoral opening wedge osteotomy (LDF-OWO) are not known. Purpose This study aimed to define changes in TT-TG distance with increasing amounts of valgus correction after LDF-OWO. Methods Three-Dimensional Computed Tomography (3D-CT) scans of six patients (two females and four males) aged between 19 and 35 years with genu valgum and patellar instability were analyzed. 3D models of femoral, tibial, and patellar bones were created with the advanced segment option of Mimics 21® software. An oblique lateral opening wedge osteotomy of the distal femur was simulated in 2-degree increments up to 12 degrees of varus opening. Change in TT-TG distance was measured in mm on 3D models of the knee. Results Compared to baseline without osteotomy, the TT-TG distance decreased significantly (p < 0.05) for all corrections from 2 to 12 degrees in 2° steps. The TT-TG distance decreased by an average of 1.7 mm for every 2 degrees of varus opening. Conclusion Lateral opening wedge distal femoral osteotomy causes a decrease in TT-TG distance. The surgeon should be aware of the magnitude of this change (1.7 mm decrease for every 2° increment of valgus opening).

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Section: Discussionmentioning

confidence: 99%

TT-TG distance decreases after open wedge distal femoral varization osteotomy in patients with genu valgum & patellar instability. A pilot 3D computed tomography simulation study

Gür,

Yapici,

Subaşi

et al. 2023

BMC Musculoskelet Disord

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“…Ceroni [31] studied the modification of the alignment between the tibial tubercle (TT) and trochlear groove (TG) that occur during guided growth. They stated that for every degree of angular correction recommend that the plate should be coapted to the bone by pre during femoral distal hemiepiphysiodesis, there is a 1 mm simultaneous lateral or medial transfer of the TT.…”

Section: Discussionmentioning

confidence: 99%

The Using of "Guided Growth" for Correction of Coronal Deformities around the Knee in Skeletally Immature Children (Systematic review and Metaanalysis)

Sawiris¹,

Abo-Seif²,

Aly³

2018

Med Clin Rev

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Introduction: Angular deformities of the lower limbs are common during childhood. The concept of guided growth using a tension band plate is a breakthrough in the surgical correction of angular deformities. This approach has yielded satisfactory results and has low complication rates. Patients and methods:We reviewed 210 papers with overall 433 patients and 809 deformities. Inclusion criteria included papers published from 2010 to 2017 in English literature. A Meta-analysis was done on 16 papers with seven outcomes: Change in mechanical axis deviation, Tibiofemoral angle, rate of excellent outcomes, implant breakage, implant migration, inadequate reduction and rebound phenomenon.Results: Thirty two studies were included. Fifteen of them studied treatment of angular deformities by guided growth, three of them discussed the complications of using guided growth and five studies discussed Biomechanics of using guided growth. Sixteen studies were included in our cumulative meta-analysis. Conclusion:Guided growth is effective in treating coronal deformities around the knee in skeletally immature children wither the cause was idiopathic or pathological. There is no limitation except if physeal bar is developed or the patient near maturity. Few complications are associated with guided growth techniques including rebound phenomenon, inadequate reduction, implant breakage and implant migration.

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“…All but one patient with Down syndrome achieved satisfactory outcomes. Guided growth correction of valgus also provides a significant correction of the TT-TG distance ( 47 ), which is beneficial in patients with open growth plates where tibial tuberosity osteotomies are contraindicated. The eight plates used for guided growth impede with MPFL reconstructions and require a certain amount of time to achieve the desired correction; therefore, they may not always be an option in patients with painful recurrent patellar instability.…”

Section: Correction Of Valgusmentioning

confidence: 99%

Management of patellar instability in skeletally immature patients

Sahin,

Tandogan,

Liebensteiner

et al. 2024

EFORT Open Reviews

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Surgical intervention is the treatment of choice for recurrent lateral patellar instability. Surgery should be considered for first time lateral patella dislocations with osteochondral fractures or underlying anatomical risk factors. Primary repair and nonanatomical imbrications/reconstructions have fallen out of favor due to abnormal biomechanics and high rates of recurrence. Anatomical reconstruction of the MPFL using a variety of auto and allograft tissues have yielded good outcomes and low redislocation rates. Physeal sparing MPFL reconstruction techniques under radiological control are safe and do not cause growth disturbance. Allografts may be indicated for hyperlax patients. Although no clear cutoff points exist, correction of valgus and excessive femoral anteversion should be considered when indicated. Osteochondral and chondral injuries are common and should be addressed during surgery for instability.

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Modification of the alignment between the tibial tubercle and the trochlear groove induced by temporary hemiepiphysiodesis for lower extremity angular deformities: a trigonometric analysis

Abstract: III.

Cited by 8 publications

References 9 publications

TT-TG distance decreases after open wedge distal femoral varization osteotomy in patients with genu valgum & patellar instability. A pilot 3D computed tomography simulation study

TT-TG distance decreases after open wedge distal femoral varization osteotomy in patients with genu valgum & patellar instability. A pilot 3D computed tomography simulation study

The Using of "Guided Growth" for Correction of Coronal Deformities around the Knee in Skeletally Immature Children (Systematic review and Metaanalysis)

Management of patellar instability in skeletally immature patients

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