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Genu valgum

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https://www.readbyqxmd.com/read/28690462/open-wedge-distal-femoral-osteotomy-accuracy-of-correction-and-patient-outcomes
#1
Osama Elattar, Ishaan Swarup, Aaron Lam, Joseph Nguyen, Austin Fragomen, S Robert Rozbruch
BACKGROUND: There is a renewed interest in joint preservation surgery, and lateral opening wedge distal femoral osteotomy (DFO), a joint-preserving procedure, has been used to treat symptomatic genu valgum when the deformity originates in the distal femur. QUESTIONS/PURPOSES: This study aimed to measure the accuracy of lateral opening wedge DFO in achieving deformity correction using radiographic parameters. In addition, the ability of lateral opening wedge DFO to improve patient outcomes as measured by Short Form Health Survey (SF-36) scores and American Academy of Orthopedic Surgeons (AAOS) lower limb module (LLM) scores leading to successful joint preservation was assessed...
July 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/28576520/clinical-characterization-of-novel-chromosome-22q13-microdeletions
#2
Jennifer F Ha, Ayesha Ahmad, Marci M Lesperance
INTRODUCTION: The advent of chromosome microarray analysis (CMA) for evaluation of patients with multiple congenital anomalies has made it possible to define chromosomal imbalances with greater precision and resolutions significantly smaller than possible by standard G-banded chromosome analysis. We describe two patients with novel chromosomal anomalies involving chromosome 22q13, a locus also associated with Phelan-McDermid syndrome (PMS). OBJECTIVE: We aim to characterize the novel phenotypic and genotypic findings of two patients with 22q13 microdeletions, distinct from PMS, comparing and contrasting with features of PMS...
April 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28541005/a-combined-closing-wedge-distal-femoral-osteotomy-and-medial-reefing-procedure-for-recurrent-patellar-dislocation-with-genu-valgum
#3
Chong Bum Chang, Gautam M Shetty, Jong Seong Lee, Young Chan Kim, Jae Ho Kwon, Kyung Wook Nha
PURPOSE: Recurrent patellar dislocation is often associated with genu valgum. The purpose of this study was to analyze the short-term results of single-incision, closing-wedge distal femoral osteotomy (CWDFO) combined with medial reefing and lateral release for recurrent patellar instability with genu valgum. MATERIALS AND METHODS: Combined CWDFO/medial reefing/lateral release was performed on 10 knees. Clinical evaluation was based on pre- and postoperative Knee Society Score (KSS) and Kujala patellofemoral score...
July 2017: Yonsei Medical Journal
https://www.readbyqxmd.com/read/28428227/mechanisms-in-endocrinology-the-multiple-facets-of-ghrh-gh-igf-i-axis-lessons-from-lifetime-untreated-isolated-gh-deficiency-due-to-a-ghrh-receptor-gene-mutation
#4
REVIEW
Manuel H Aguiar-Oliveira, Anita H O Souza, Carla R P Oliveira, Viviane C Campos, Luíz A Oliveira-Neto, Roberto Salvatori
Twenty years ago, we described kindred of 105 individuals with isolated GH deficiency (IGHD) in Itabaianinha County, in northeast Brazil, carrying a homozygous mutation in the GH-releasing hormone receptor gene. These subjects exhibit markedly reduced GH responsiveness to stimulatory tests, and anterior pituitary hypoplasia. Serum concentrations of IGF-I, IGF binding protein type 3 and the acid-labile subunit are markedly reduced, with a lesser reduction of IGF-II. The most striking physical findings of these IGHD individuals are the proportionate short stature, doll facies, high-pitched voice and visceral obesity with reduced fat-free mass...
August 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28318932/patellar-instability-treated-with-distal-femoral-osteotomy
#5
Ishaan Swarup, Osama Elattar, S Robert Rozbruch
BACKGROUND: Patellar instability can cause significant disability in both pediatric and adult patients, and it is associated with several factors including genu valgum. In this study, we describe the role of a lateral opening wedge distal femoral osteotomy (DFO) combined with lateral retinacular release in addressing genu valgum with associated patellar instability. The rationale for this approach is to medialize the patellar tendon insertion and decrease the Q angle with DFO. METHODS: A consecutive series of patients were studied, and our outcomes of interest included improvements in radiographic measures and patient outcomes...
March 17, 2017: Knee
https://www.readbyqxmd.com/read/28288078/idiopathic-genu-valgum-and-its-association-with-obesity-in-children-and-adolescents
#6
Janet L Walker, Pooya Hosseinzadeh, Hank White, Kevin Murr, Todd A Milbrandt, Vishwas J Talwalkar, Henry Iwinski, Ryan Muchow
BACKGROUND: Obesity as a cause of lower extremity deformity in children has been well established. This deformity is most often seen as tibia vara, however, at our institution we have observed more obese children and adolescents over age 7 years with excessive or progressive idiopathic genu valgum. Our hypothesis is that children with idiopathic genu valgum have high rates of obesity which impact the severity of their disease. METHODS: Retrospective review of existing data was performed on 66 consecutive children/112 limbs over age 7 years with idiopathic genu valgum, seen from 2010 to 2013...
March 10, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28222650/is-surgery-always-indicated-in-rachitic-coronal-knee-deformities-our-experience-in-198-knees
#7
Jatin Prakash, Anil Mehtani, Alok Sud, Baccha K Reddy
INTRODUCTION: Defective mineralization of osteoid matrix prior to physeal closure causes rickets. Poor calcification of the cartilage matrix in the zone of provisional calcification causes flattened skull, rachitic rosary, bowed legs, coxa vara and brittle bones. The recent literature has seen an increase in the incidence of the disease in both developing and developed nations. We evaluated behaviour of lower limb deformities due to nutritional rickets in 117 patients. MATERIALS AND METHODS: A prospective study was conducted from January 2009 to December 2011 for clinical and radiological evaluation of knee deformities in nutritional rickets...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28194384/correlation-between-ahlb%C3%A3-ck-radiographic-classification-and-anterior-cruciate-ligament-status-in-primary-knee-arthrosis
#8
Glaucus Cajaty Martins, Gilberto Luis Camanho, Leonardo Marcolino Ayres, Eduardo Soares de Oliveiras
OBJECTIVE: To correlate the Ahlbäck radiographic classification with the anterior cruciate ligament (ACL) status in knee arthritis patients. METHODS: The study evaluated 89 knees of patients who underwent total knee arthroplasty due to primary osteoarthritis: 16 male and 69 females, with mean age 69.79 years (53-87 years). Osteoarthritis was classified radiographically by the Ahlbäck radiographic classification into five grades. The ACL was classified in the surgery as present or absent...
January 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28149734/medial-closing-wedge-distal-femoral-osteotomy-for-genu-valgum-with-lateral-compartment-disease
#9
James D Wylie, Travis G Maak
Lateral compartment disease combined with valgus alignment can lead to progressive knee joint degeneration. In the symptomatic patient with isolated lateral compartment disease, a varus-producing distal femoral osteotomy can unload the diseased lateral compartment. This osteotomy may be combined with other cartilage or meniscal restorative techniques to optimize knee joint preservation and pain relief. The osteotomy can be performed with a medial closing-wedge or lateral opening-wedge technique. Both techniques have been reported to improve knee-related quality of life in patients with lateral compartment disease...
December 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28141690/predicting-late-follow-up-and-understanding-its-consequences-in-growth-modulation-for-pediatric-lower-limb-deformities
#10
Cheryl Lawing, Adam Margalit, Gift Ukwuani, Paul D Sponseller
BACKGROUND: Growth modulation with implants facilitates correction of angular deformities and limb-length discrepancies (LLDs) in children. Close follow-up is necessary when using growth modulation to prevent overcorrection. We examined factors associated with late follow-up and overcorrection rates in patients with late versus timely follow-up. METHODS: This was a retrospective review of growth modulation procedures in children at 1 institution from 2000 through 2014...
January 30, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28141689/radiographic-assessment-of-guided-growth-the-correlation-between-screw-divergence-and-change-in-anatomic-alignment
#11
Kyle R Sweeney, Weilong J Shi, Michael B Gottschalk, Jason E Kappa, Robert W Bruce, Nicholas D Fletcher
BACKGROUND: Assessment of changes in anatomic alignment following guided growth traditionally utilizes full-length standing radiographs which subjects patients to larger radiation doses than does a single anteroposterior radiograph of the knee. In an effort to minimize radiation exposure, the present study sought to determine whether changes in screw divergence (SD) of the 2-hole tension band plate used for hemiepiphysiodesis reliably predicts change in alignment. METHODS: A retrospective review was conducted involving all patients with genu varum or genu valgum treated with hemiepiphysiodesis at a single institution...
June 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28089797/distal-femoral-hemiepiphysiodesis-using-screw-and-non-absorbable-filament-for-the-treatment-of-idiopathic-genu-valgum-preliminary-results-of-12-knees
#12
G Martínez, S Drago, C Avilés, A Ibañez, F Hodgson, C Ramírez
INTRODUCTION: Different techniques for gradual correction of angular deformities of lower limbs exist. Screws and nonabsorbable filament has been described as an effective alternative for transitory hemiepiphysiodesis in New Zealand rabbits. HYPOTHESIS: Hemiepiphysiodesis using screws and non-absorbable filament is effective in pediatric population, for correction of genu valgum. METHODS: Retrospective evaluation, 12 knees in 6 patients younger than 15 years (3 female), operated because of genu valgum...
April 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28041741/is-there-a-correlation-between-the-change-in-the-interscrew-angle-of-the-eight-plate-and-the-delta-joint-orientation-angles
#13
Salih Marangoz, Kadir Buyukdogan, Sevilay Karahan
OBJECTIVES: It is known that the screws of the eight-plate hemiepiphysiodesis construct diverge as growth occurs through the physis. Our objective was to investigate whether there is a correlation between the amount of change of the joint orientation angle (JOA) and that of the interscrew angle (ISA) of the eight-plate hemiepiphysiodesis construct before and after correction. PATIENTS AND METHODS: After the institutional review board approval, medical charts and X-rays of all patients operated for either genu valgum or genu varum with eight-plate hemiepiphysiodesis were analyzed retrospectively...
January 2017: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/27979613/mucopolysaccharidosis-iva-and-glycosaminoglycans
#14
REVIEW
Shaukat Khan, Carlos J Alméciga-Díaz, Kazuki Sawamoto, William G Mackenzie, Mary C Theroux, Christian Pizarro, Robert W Mason, Tadao Orii, Shunji Tomatsu
Mucopolysaccharidosis IVA (MPS IVA; Morquio A: OMIM 253000) is a lysosomal storage disease with an autosomal recessive trait caused by the deficiency of N-acetylgalactosamine-6-sulfate sulfatase. Deficiency of this enzyme leads to accumulation of specific glycosaminoglycans (GAGs): chondroitin-6-sulfate (C6S) and keratan sulfate (KS). C6S and KS are mainly produced in the cartilage. Therefore, the undegraded substrates are stored primarily in cartilage and in its extracellular matrix (ECM), leading to a direct impact on cartilage and bone development, and successive systemic skeletal dysplasia...
January 2017: Molecular Genetics and Metabolism
https://www.readbyqxmd.com/read/27920870/pyle-disease-metaphyseal-dysplasia-presenting-in-two-adult-sisters
#15
Diego Ximenes Soares, Amália Mapurunga Almeida, André Rodrigues Façanha Barreto, Ilze Jucá Alencar E Silva, José Daniel Vieira de Castro, Francisco José Magalhães Pinto, Daniel Aguiar Dias, Lindenberg Barbosa Aguiar
Pyle's disease is an extremely rare skeletal disorder characterized by a benign course and an autosomal recessive genetic pattern of inheritance. Its causal mutation is still unknown. In the medical literature, fewer than 30 cases have been described to date. We report the case of two female siblings, daughters of consanguineous parents, referred to the radiology department complaining of genu valgum. Laboratory tests showed no other relevant findings. Conventional radiography plain films revealed Erlenmeyer flask deformity in bilateral femorotibial metaphyses, metaphyseal flaring of long bones, and mild sclerosis of the skull base...
December 2016: Radiology case reports
https://www.readbyqxmd.com/read/27869739/perinatal-risk-factors-and-genu-valgum-conducive-to-the-onset-of-growing-pains-in-early-childhood
#16
Angelos Kaspiris, Efstathios Chronopoulos, Elias Vasiliadis
The most prevalent musculoskeletal disorder of childhood with unclear aetiology is growing pains (GPs). Anatomic deformities and factors that change bone turnover are implicated in GP pathophysiology. Perinatal risk factors alter the bone metabolism affecting the bone mineral density and content. The aim of our study was to analyze the relationship between GPs, knock knees and perinatal factors. The examined population consisted of 276 children aged 3-7 years. Among them, ten pairs of dizygotic twins were evaluated...
November 18, 2016: Children
https://www.readbyqxmd.com/read/27818987/total-knee-arthroplasty-with-subvastus-approach-in-patient-with-chronic-post-traumatic-patellar-dislocation
#17
Jader Joel Machado Junqueira, Camilo Partezani Helito, Marcelo Batista Bonadio, Jose Ricardo Pécora, Marco Kawamura Demange
Chronic lateral dislocation of the patella is a rare condition and acquired causes are usually secondary to knee trauma. The neglected chronic dislocation leads to progressive genu valgum and external tibial torsion deformities with subsequent gonarthrosis, which becomes painful and debilitating. There is no consensus regarding treatment of these patients, but total knee arthroplasty (TKA) is a useful therapy in cases of painful symptomatic gonarthrosis. Few reports have shown that subvastus approach and lateral release may be a valid option for TKA, since it allows the correction of valgus deformity and patellar tracking without interrupting vascular blood supply of patella...
September 2016: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/27777911/long-term-clinical-outcome-and-the-identification-of-homozygous-cyp27b1-gene-mutations-in-a-patient-with-vitamin-d-hydroxylation-deficient-rickets-type-1a
#18
Ja Hyang Cho, Eungu Kang, Gu-Hwan Kim, Beom Hee Lee, Jin-Ho Choi, Han-Wook Yoo
Vitamin D hydroxylation-deficient rickets type 1A (VDDR1A) is an autosomal recessively-inherited disorder caused by mutations in CYP27B1 encoding the 1α-hydroxylase enzyme. We report on a female patient with VDDR1A who presented with hypocalcemic seizure at the age of 13 months. The typical clinical and biochemical features of VDDR1A were found, such as hypocalcemia, increased alkaline phosphatase, secondary hyperparathyroidism and normal 25-hydroxyvitamin D3 (25(OH)D3). Radiographic images of the wrist showed metaphyseal widening with cupping and fraying of the ulna and distal radius, suggesting rickets...
September 2016: Annals of Pediatric Endocrinology & Metabolism
https://www.readbyqxmd.com/read/27587531/prediction-of-rebound-phenomenon-after-removal-of-hemiepiphyseal-staples-in-patients-with-idiopathic-genu-valgum-deformity
#19
COMPARATIVE STUDY
S-S Park, S Kang, J Y Kim
AIMS: Our aim was to investigate the predictive factors for the development of a rebound phenomenon after temporary hemiepiphysiodesis in children with genu valgum. PATIENTS AND METHODS: We studied 37 limbs with idiopathic genu valgum who were treated with hemiepiphyseal stapling, and with more than six months remaining growth at removal of the staples. All children were followed until skeletal maturity or for more than two years after removal of the staples. RESULTS: On multivariate logistic regression analysis, the rate of correction, body mass index (BMI), age, and initial valgus angle were significantly associated with a rebound phenomenon...
September 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27585448/role-of-computer-assisted-surgery-in-osteotomies-around-the-knee
#20
D Saragaglia, B Chedal-Bornu, R C Rouchy, B Rubens-Duval, R Mader, R Pailhé
PURPOSE: The goal of this article is to present our experience on navigation for osteotomies around the knee and especially osteotomies for coronal deformities. The first computer-assisted osteotomy was performed in March 2001 and since that time more than 1000 osteotomies have been performed in our department. METHODS: All the osteotomies were performed with the Orthopilot(®) device (B-Braun-Aesculap, Tuttlingen, Germany). The main indication was for genu varum deformities but several cases were operated for genu valgum...
November 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
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