Blount disease

Journal of Bone and Joint Surgery

Volumn 91, Issue 7, 2009, Pages 1758-1776

  Sabharwal, Sanjeev ^a  

^a RUTGERS NEW JERSEY MEDICAL SCHOOL   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTHROGRAPHY; BLOUNT DISEASE; BONE MALFORMATION; BONE MATURATION; BONE SCREW; BRACE; CARTILAGE CELL; DISEASE ASSOCIATION; DISEASE CLASSIFICATION; DISTRACTION OSTEOGENESIS; EPIPHYSIS; FIXATION DEVICE; FRACTURE EXTERNAL FIXATION; FRACTURE FIXATION; HUMAN; INTRAOPERATIVE PERIOD; KNEE; KNEE ARTHROPLASTY; KNEE RADIOGRAPHY; METAPHYSIS; OBESITY; ONSET AGE; ORTHOSIS; OSSIFICATION; OSTEOTOMY; PATHOGENESIS; POSTOPERATIVE PERIOD; PRIORITY JOURNAL; PROGNOSIS; REVIEW; SURGICAL TECHNIQUE; TIBIA OSTEOTOMY; BONE DYSPLASIA; CHILD; CONGENITAL MALFORMATION; PATHOPHYSIOLOGY; TIBIA;

AGE OF ONSET; BONE DISEASES, DEVELOPMENTAL; CHILD; HUMANS; TIBIA;

EID: 67651148519     PISSN: 00219355     EISSN: None     Source Type: Journal    
DOI: 10.2106/JBJS.H.01348     Document Type: Review

References (104)

1. Blount WP. Tibia vara. Osteochondrosis deformans tibiae. J Bone Joint Surg. 1937;19:1-29.
2. Langenskiöld A. Tibia vara; (osteochondrosis deformans tibiae); a survey of 23 cases. Acta Chir Scand. 1952;103:1-22.
3. Golding JSR, McNeil-Smith JDG. Observations on the etiology of tibia vara. J Bone Joint Surg Br. 1963;45:320-325
4. Sabharwal S, Lee J Jr, Zhao C. Multiplanar deformity analysis of untreated Blount disease. J Pediatr Orthop. 2007;27:260-265 (Pubitemid 46573175)
5. Siffert RS, Katz JF. The intra-articular deformity in osteochondrosis deformans tibiae. J Bone Joint Surg Am. 1970;52:800-804
6. Hofmann A, Jones RE, Herring JA. Blount's disease after skeletal maturity. J Bone Joint Surg Am. 1982;64:1004-1009
7. Ingvarsson T, Hägglund G, Ramgren B, Jonsson K, Zayer M. Long-term results after adolescent Blount's disease. J Pediatr Orthop B. 1997;6:153-156 (Pubitemid 27419388)
8. Zayer M. Osteoarthritis following Blount's disease. Int Orthop. 1980;4:63-66
9. Thompson GH, Carter JR. Late-onset tibia vara (Blount's disease). Current concepts. Clin Orthop Relat Res. 1990;255:24-35.
10. Carter JR, Leeson MC, Thompson GH, Kalamchi A, Kelly CM, Makley JT. Late-onset tibia vara: a histopathologic analysis. A comparative evaluation with infantile tibia vara and slipped capital femoral epiphysis. J Pediatr Orthop. 1988;8:187-195 (Pubitemid 18096723)
11. Wenger DR, Mickelson M, Maynard JA. The evolution and histopathology of adolescent tibia vara. J Pediatr Orthop. 1984;4:78-88. (Pubitemid 14164428)
12. Stricker SJ, Edwards PM, Tidwell MA. Langenskiöld classification of tibia vara: an assessment of interobserver variability. J Pediatr Orthop. 1994;14:152-155
13. Loder RT, Johnston CE 2nd. Infantile tibia vara. J Pediatr Orthop. 1987;7:639-646
14. Cook SD, Lavernia CJ, Burke SW, Skinner HB, Haddad RJ Jr. A biomechanical analysis of the etiology of tibia vara. J Pediatr Orthop. 1983;3:449-454
15. Davids JR, Huskamp M, Bagley AM. A dynamic biomechanical analysis of the etiology of adolescent tibia vara. J Pediatr Orthop. 1996;16:461-468 (Pubitemid 26186116)
16. Dietz WH Jr, Gross WL, Kirkpatrick JA Jr. Blount disease (tibia vara): another skeletal disorder associated with childhood obesity. J Pediatr. 1982;101:735-737
17. Gushue DL, Houck J, Lerner AL. Effects of childhood obesity on three-dimensional knee joint biomechanics during walking. J Pediatr Orthop. 2005;25:763-768 (Pubitemid 41546412)
18. Sabharwal S, Zhao C, McClemens E. Correlation of body mass index and radiographic deformities in children with Blount disease. J Bone Joint Surg Am. 2007;89:1275-1283 (Pubitemid 46897999)
19. Johnston CE 2nd. Infantile tibia vara. Clin Orthop Relat Res. 1990;255:13-23.
20. Trueta J, Trias A. The vascular contribution to osteogenesis. IV. Effect of pressure upon the epiphysial cartilage of the rabbit. J Bone Joint Surg Br. 1961;43:800-813
21. Henderson RC, Greene WB. Etiology of late-onset tibia vara: is varus alignment a prerequisite? J Pediatr Orthop. 1994;14:143-146
22. Whiting SJ. Obesity is not protective for bones in childhood and adolescence. Nutr Rev. 2002;60:27-30.
23. Bathfield CA, Beighton PH. Blount disease. A review of etiological factors in 110 patients. Clin Orthop Relat Res. 1978;135:29-33.
24. Auerbach JD, Radomisli TE, Simoncini J, Ulin RI. Variability of the metaphyseal-diaphyseal angle in tibia vara: a comparison of two methods. J Pediatr Orthop. 2004;24:75-78 (Pubitemid 38030051)
25. Feldman MD, Schoenecker PL. Use of the metaphyseal-diaphyseal angle in the evaluation of bowed legs. J Bone Joint Surg Am. 1993;75:1602-1609
26. Foreman KA, Robertson WW Jr. Radiographic measurement of infantile tibia vara. J Pediatr Orthop. 1985;5:452-455
27. Levine AM, Drennan JC. Physiological bowing and tibia vara. The metaphyseal-diaphyseal angle in the measurement of bowleg deformities. J Bone Joint Surg Am. 1982;64:1158-1163
28. Davids JR, Blackhurst DW, Allen BL Jr. Radiographic evaluation of bowed legs in children. J Pediatr Orthop. 2001;21:257-263
29. Bowen RE, Dorey FJ, Moseley CF. Relative tibial and femoral varus as a predictor of progression of varus deformities of the lower limbs in young children. J Pediatr Orthop. 2002;22:105-111
30. McCarthy JJ, Betz RR, Kim A, Davids JR, Davidson RS. Early radiographic differentiation of infantile tibia vara from physiologic bowing using the femoral-tibial ratio. J Pediatr Orthop. 2001;21:545-548 (Pubitemid 32613567)
31. Hägglund G, Ingvarsson T, Ramgren B, Zayer M. Metaphyseal-diaphyseal angle in Blount's disease. A 30-year follow-up of 13 unoperated children. Acta Orthop Scand. 1997;68:167-169
32. Paley D. Principle of deformity correction. Berlin: Springer; 2002.
33. Stricker SJ, Faustgen JP. Radiographic measurement of bowleg deformity: variability due to method and limb rotation. J Pediatr Orthop. 1994;14:147-151
34. Gordon JE, King DJ, Luhmann SJ, Dobbs MB, Schoenecker PL. Femoral deformity in tibia vara. J Bone Joint Surg Am. 2006;88:380-386
35. Kline SC, Bostrum M, Griffin PP. Femoral varus: an important component in late-onset Blount's disease. J Pediatr Orthop. 1992;12:197-206.
36. Myers TG, Fishman MK, McCarthy JJ, Davidson RS, Gaughan J. Incidence of distal femoral and distal tibial deformities in infantile and adolescent Blount disease. J Pediatr Orthop. 2005;25:215-218 (Pubitemid 40315441)
37. Sabharwal S. Blount's disease. In: Rozbruch SR, Ilizarov S, editors. Limb lengthening and reconstruction surgery. New York: Taylor and Francis; 2006. p 511-520
38. Craig JG, van Holsbeeck M, Zaltz I. The utility of MR in assessing Blount disease. Skeletal Radiol. 2002;31:208-213
39. Stanitski DF, Stanitski CL, Trumble S. Depression of the medial tibial plateau in early-onset Blount disease: myth or reality? J Pediatr Orthop. 1999;19:265-269 (Pubitemid 29129635)
40. Dalinka MK, Coren G, Hensinger R, Irani RN. Arthrography in Blount's disease. Radiology. 1974;113:161-164
41. Haddad FS, Harper GD, Hill RA. Intraoperative arthrography and the Ilizarov technique. Role in the correction of paediatric deformity and leg lengthening. J Bone Joint Surg Br. 1997;79:731-733
42. Ducou le Pointe H, Mousselard H, Rudelli A, Montagne JP, Filipe G. Blount's disease: magnetic resonance imaging. Pediatr Radiol. 1995;25:12-14
43. Mukai S, Suzuki S, Seto Y, Kashiwagi N, Hwang ES. Early characteristic findings in bowleg deformities: evaluation using magnetic resonance imaging. J Pediatr Orthop. 2000;20:611-615 (Pubitemid 30688840)
44. Arai K, Haga N, Taniguchi K, Nakamura K. Magnetic resonance imaging findings and treatment outcome in late-onset tibia vara. J Pediatr Orthop. 2001;21:808-811 (Pubitemid 33021167)
45. Synder M, Vera J, Harcke HT, Bowen JR. Magnetic resonance imaging of the growth plate in late-onset tibia vara. Int Orthop. 2003;27:217-222 (Pubitemid 37070879)
46. Hosalkar HS, Jones S, Hartley J, Hill R. Three-dimensional tomography of relapsed infantile Blount's disease. Clin Orthop Relat Res. 2005;431:176-180 (Pubitemid 40194233)
47. Raney EM, Topoleski TA, Yaghoubian R, Guidera KJ, Marshall JG. Orthotic treatment of infantile tibia vara. J Pediatr Orthop. 1998;18:670-674 (Pubitemid 28446823)
48. Richards BS, Katz DE, Sims JB. Effectiveness of brace treatment in early infantile Blount's disease. J Pediatr Orthop. 1998;18:374-380
49. Zionts LE, Shean CJ. Brace treatment of early infantile tibia vara. J Pediatr Orthop. 1998;18:102-109 (Pubitemid 28051578)
50. Shinohara Y, Kamegaya M, Kuniyoshi K, Moriya H. Natural history of infantile tibia vara. J Bone Joint Surg Br. 2002;84:263-268 (Pubitemid 34257696)
51. Ferriter P, Shapiro F. Infantile tibia vara: factors affecting outcome following proximal tibial osteotomy. J Pediatr Orthop. 1987;7:1-7. (Pubitemid 17228454)
52. Chotigavanichaya C, Salinas G, Green T, Moseley CF, Otsuka NY. Recurrence of varus deformity after proximal tibial osteotomy in Blount disease: long-term follow-up. J Pediatr Orthop. 2002;22:638-41. Erratum in: J Pediatr Orthop. 2004;24:599. (Pubitemid 34966810)
53. Doyle BS, Volk AG, Smith CF. Infantile Blount disease: long-term follow-up of surgically treated patients at skeletal maturity. J Pediatr Orthop. 1996;16:469-476
54. Schoenecker PL, Meade WC, Pierron RL, Sheridan JJ, Capelli AM. Blount's disease: a retrospective review and recommendations for treatment. J Pediatr Orthop. 1985;5:181-186 (Pubitemid 15100258)
55. Gordon JE, Hughes MS, Shepherd K, Szymanski DA, Schoenecker PL, Parker L, Uong EC. Obstructive sleep apnoea syndrome in morbidly obese children with tibia vara. J Bone Joint Surg Br. 2006;88:100-103 (Pubitemid 43125322)
56. Raffini L, Horn D, Dormans J, Manno C. Deep vein thrombosis and pulmonary emobolism after orthopaedic surgery in a children's hospital. Presented as an Eposter exhibit at the Annual Meeting of the Pediatric Orthopaedic Society of North America; 2008 Apr 29-May 3; Albuquerque, NM.
57. Blount WP, Clarke GR. Control of bone growth by epiphyseal stapling; a preliminary report. J Bone Joint Surg Am. 1949;31:464-478
58. Castañeda P, Urquhart B, Sullivan E, Haynes RJ. Hemiepiphysiodesis for the correction of angular deformity about the knee. J Pediatr Orthop. 2008;28:188-191
59. Henderson RC, Kemp GJ Jr, Greene WB. Adolescent tibia vara: alternatives for operative treatment. J Bone Joint Surg Am. 1992;74:342-350
60. Park SS, Gordon JE, Luhmann SJ, Dobbs MB, Schoenecker PL. Outcome of hemiepiphyseal stapling for late-onset tibia vara. J Bone Joint Surg Am. 2005;87:2259-2266
61. Stevens PM. Guided growth for angular correction: a preliminary series using a tension band plate. J Pediatr Orthop. 2007;27:253-259
62. Westberry DE, Davids JR, Pugh LI, Blackhurst D. Tibia vara: results of hemiepiphyseodesis. J Pediatr Orthop B. 2004;13:374-378
63. McIntosh AL, Hanson C, Rathjen K. The treatment of adolescent Blount's disease with hemiepiphysieodesis: risk factors for failure. Presented at the Annual Meeting of the Pediatric Orthopaedic Society of North America; 2008 Apr 29-May 3; Albuquerque, NM.
64. Schroerlucke SR, Bertrand SL, Fields L, Clapp J, Burdy JV, Zhou H, Gregg FN. Failure of Orthofix eight-plate for the treatment of adolescent Blount's disease. Presented at the annual meeting of the Pediatric Orthopaedic Society of North America; 2008 April 29-May 3; Albuquerque, NM.
65. Schoenecker PL, Johnston R, Rich MM, Capelli AM. Elevation of the medial plateau of the tibia in the treatment of Blount disease. J Bone Joint Surg Am. 1992;74:351-358
66. Martin SD, Moran MC, Martin TL, Burke SW. Proximal tibial osteotomy with compression plate fixation for tibia vara. J Pediatr Orthop. 1994;14:619-622
67. Miller S, Radomisli T, Ulin R. Inverted arcuate osteotomy and external fixation for adolescent tibia vara. J Pediatr Orthop. 2000;20:450-454 (Pubitemid 30460606)
68. Smith CF. Tibia vara (Blount's disease). J Bone Joint Surg Am. 1982;64:630-632
69. Hayek S, Segev E, Ezra E, Lokiec F, Wientroub S. Serrated W/M osteotomy. Results using a new technique for the correction of infantile tibia vara. J Bone Joint Surg Br. 2000;82:1026-1029
70. Rab GT. Oblique tibial osteotomy for Blount's disease (tibia vara). J Pediatr Orthop. 1988;8:715-720
71. Loder RT, Schaffer JJ, Bardenstein MB. Late-onset tibia vara. J Pediatr Orthop. 1991;11:162-167
72. Laurencin CT, Ferriter PJ, Millis MB. Oblique proximal tibial osteotomy for the correction of tibia vara in the young. Clin Orthop Relat Res. 1996;327:218-224 (Pubitemid 26174177)
73. Price CT, Scott DS, Greenberg DA. Dynamic axial external fixation in the surgical treatment of tibia vara. J Pediatr Orthop. 1995;15:236-243
74. Smith SL, Beckish ML, Winters SC, Pugh LI, Bray EW. Treatment of late-onset tibia vara using Afghan percutaneous osteotomy and Orthofix external fixation. J Pediatr Orthop. 2000;20:606-610
75. Stanitski DF, Srivastava P, Stanitski CL. Correction of proximal tibial deformities in adolescents with the T-Garches external fixator. J Pediatr Orthop. 1998;18:512-517 (Pubitemid 28435470)
76. Gaudinez R, Adar U. Use of Orthofix T-Garche fixator in late-onset tibia vara. J Pediatr Orthop. 1996;16:455-460 (Pubitemid 26186115)
77. Payman KR, Patenall V, Borden P, Green T, Otsuka NY. Complications of tibial osteotomies in children with comorbidities. J Pediatr Orthop. 2002;22:642-644 (Pubitemid 34966811)
78. Pinkowski JL, Weiner DS. Complications in proximal tibial osteotomies in children with presentation of technique. J Pediatr Orthop. 1995;15:307-312
79. Steel HH, Sandrow RE, Sullivan PD. Complications of tibial osteotomy in children for genu varum or valgum. Evidence that neurological changes are due to ischemia. J Bone Joint Surg Am. 1971;53:1629-1635
80. Alekberov C, Shevtsov VI, Karatosun V, Günal I, Alici E. Treatment of tibia vara by the Ilizarov method. Clin Orthop Relat Res. 2003;409:199-208. (Pubitemid 36417730)
81. Coogan PG, Fox JA, Fitch RD. Treatment of adolescent Blount disease with the circular external fixation device and distraction osteogenesis. J Pediatr Orthop. 1996;16:450-454
82. de Pablos J, Azcárate J, Barrios C. Progressive opening-wedge osteotomy for angular long-bone deformities in adolescents. J Bone Joint Surg Br. 1995;77:387-391
83. Gordon JE, Heidenreich FP, Carpenter CJ, Kelly-Hahn J, Schoenecker PL. Comprehensive treatment of late-onset tibia vara. J Bone Joint Surg Am. 2005;87:1561-1570 (Pubitemid 40917757)
84. Stanitski DF, Dahl M, Louie K, Grayhack J. Management of late-onset tibia vara in the obese patient by using circular external fixation. J Pediatr Orthop. 1997;17:691-694 (Pubitemid 28048758)
85. Feldman DS, Madan SS, Koval KJ, van Bosse HJ, Bazzi J, Lehman WB. Correction of tibia vara with six-axis deformity analysis and the Taylor Spatial Frame. J Pediatr Orthop. 2003;23:387-391 (Pubitemid 36529595)
86. Fadel M, Hosny G. The Taylor spatial frame for deformity correction in the lower limbs. Int Orthop. 2005;29:125-129 (Pubitemid 40558563)
87. Kristiansen LP, Steen H, Reikerås O. No difference in tibial lengthening index by use of Taylor spatial frame or Ilizarov external fixator. Acta Orthop. 2006;77:772-777 (Pubitemid 44521918)
88. Matsubara H, Tsuchiya H, Sakurakichi K, Watanabe K, Tomita K. Deformity correction and lengthening of lower legs with an external fixator. Int Orthop. 2006;30:550-554 (Pubitemid 44900568)
89. Feldman DS, Madan SS, Ruchelsman DE, Sala DA, Lehman WB. Accuracy of correction of tibia vara: acute versus gradual correction. J Pediatr Orthop. 2006;26:794-798
90. Gregosiewicz A, Wósko I, Kandzierski G, Drabik Z. Double-elevating osteotomy of tibiae in the treatment of severe cases of Blount's disease. J Pediatr Orthop. 1989;9:178-181 (Pubitemid 19066866)
91. Sabharwal S, Zhao C. Assessment of lower limb alignment: supine fluoroscopy compared with a standing full-length radiograph. J Bone Joint Surg Am. 2008;90:43-51.
92. Sabharwal S, Zhao C, Edgar M. Lower limb alignment in children. Reference values based on a full-length standing radiograph. J Pediatr Orthop. 2008;28:740-746
93. de Pablos J, Franzreb M. Treatment of adolescent tibia vara by asymmetrical physeal distraction. J Bone Joint Surg Br. 1993;75:592-596 (Pubitemid 23222134)
94. Langenskiöld A, Riska EB. Tibia vara (osteochondrosis deformans tibiae): a survey of seventy-one cases. J Bone Joint Surg Am. 1964;46:1405-1420
95. Andrade N, Johnston CE. Medial epiphysiolysis in severe infantile tibia vara. J Pediatr Orthop. 2006;26:652-658 (Pubitemid 44315848)
96. Beck CL, Burke SW, Roberts JM, Johnston CE 2nd. Physeal bridge resection in infantile Blount disease. J Pediatr Orthop. 1987;7:161-163
97. Jones S, Hosalkar HS, Hill RA, Hartley J. Relapsed infantile Blount's disease treated by hemiplateau elevation using the Ilizarov frame. J Bone Joint Surg Br. 2003;85:565-571 (Pubitemid 36621977)
98. Storen H. Operative elevation of the medial tibial joint surface in Blount's disease. One case observed for 18 years after operation. Acta Orthop Scand. 1969;40:788-796
99. Accadbled F, Laville JM, Harper L. One-step treatment for evolved Blount's disease: four cases and review of the literature. J Pediatr Orthop. 2003;23:747-752 (Pubitemid 37323061)
100. Tavares JO, Molinero K. Elevation of medial tibial condyle for severe tibia vara. J Pediatr Orthop B. 2006;15:362-369 (Pubitemid 44197564)
101. van Huyssteen A, Hastings C, Olesak M, Hoffman E. Double-elevating osteotomy for late-presenting infantile Blount's disease. J Bone Joint Surg Br. 2005;87:710-715
102. Hefny H, Shalaby H, El-Kawy S, Thakeb M, Elmoatasem E. A new double elevating osteotomy in management of severe neglected infantile tibia vara using the Ilizarov technique. J Pediatr Orthop. 2006;26:233-237 (Pubitemid 44357092)
103. Ingvarsson T, Hägglund G, Ramgren B, Jonsson K, Zayer M. Long-term results after infantile Blount's disease. J Pediatr Orthop B. 1998;7:226-229 (Pubitemid 28365722)
104. Greene WB. Infantile tibia vara. J Bone Joint Surg Am. 1993;75:130-143