Temporary hemiepiphysiodesis for correction of genu valgum due to cystinosis: a preliminary interventional study in children

Abstract

Background: Few studies have assessed the efficacy of temporary hemiepiphysiodesis in the treatment of genu valgum in patients with cystinosis. In the present study, the authors aimed to assess the postsurgical outcome of temporary hemiepiphysiodesis for genu valgum in patients with cystinosis. Methods: In this case series study, the inclusion criterion was the occurrence of genu valgum due to definitive diagnosis of cystinosis that was treated with temporary hemiepiphysiodesis technique. The lateral distal femoral angle (LDFA) and medial proximal tibial angle (MPTA) were measured before and 6 to 12 mo after the operation. Surgical complications also were assessed within the mean follow-up time of 40.21±19.86 mo. Results: Overall, 14 patients undergoing temporary hemiepiphysiodesis due to genu valgum after cystinosis were assessed. The mean age was 10.00±2.41 yr (male 35.7%, female 64.3%). Hemiepiphysiodesis led to significantly increased LDFA in both left side (from 79.64±3.89 to 88.28±1.26, P=0.001) and right side (from 79.42±2.59 to 89.57±1.69, P=0.001). The change in MPTA in left side (from 88.21±1.36 to 86.07±1.32, P=0.001) and right side (from 88.35±2.49 to 86.42±1.74, P=0.016) also was significant. Conclusions: Temporary hemiepiphysiodesis is a reproducible, efficient, and safe approach for correction of genu valgum in patients with cystinosis with low and amendable complications in a short stature patient. Level of Evidence: Level III.