Lower extremity deformity and its risk factors in patients with solitary osteochondromas.
Deformity
Osteochondroma
Risk factor
Solitary
Journal
Journal of orthopaedic surgery and research
ISSN: 1749-799X
Titre abrégé: J Orthop Surg Res
Pays: England
ID NLM: 101265112
Informations de publication
Date de publication:
19 Jul 2024
19 Jul 2024
Historique:
received:
21
01
2024
accepted:
09
07
2024
medline:
20
7
2024
pubmed:
20
7
2024
entrez:
19
7
2024
Statut:
epublish
Résumé
This study aimed to demonstrate the occurrence of lower extremity deformities and their risk factors in patients with solitary osteochondromas. We retrospectively reviewed consecutive patients with solitary osteochondromas around the knee. The laterality (left or right), involved bone (femur or tibia), tumor type (pedunculated or sessile), and direction (medial or lateral) were examined. The whole limb length (WLL), mechanical lateral distal femoral angle (mLDFA), and medial proximal tibial angle (MPTA) were measured using teleroentgenogram. Lower limb deformity was defined as a difference of more than 5° in mLDFA or MPTA in both lower extremities or a difference in WLL of more than 1 cm. Patients were divided into two groups, with deformity and without deformity. Lower extremity deformities were observed in 8 of 83 patients. Significant difference in the type of osteochondroma (p = 0.004) between the groups was observed. Differences in sex, age, laterality, involved bone, direction, and distance from the physis to the osteochondroma between groups were not statistically significant. The sessile type of osteochondroma was a risk factor for lower limb deformity with an odds ratio of 24.0 according to Firth's logistic regression analysis. In our cohort with solitary osteochondroma, lower limb deformities were observed in 8 (9.6%) out of the 83 patients and these were significantly associated with sessile-type tumors. Therefore, patients with sessile-type solitary osteochondroma around the knee require careful surveillance of lower limb alignment with whole leg teleroentgenogram.
Sections du résumé
BACKGROUND
BACKGROUND
This study aimed to demonstrate the occurrence of lower extremity deformities and their risk factors in patients with solitary osteochondromas.
METHODS
METHODS
We retrospectively reviewed consecutive patients with solitary osteochondromas around the knee. The laterality (left or right), involved bone (femur or tibia), tumor type (pedunculated or sessile), and direction (medial or lateral) were examined. The whole limb length (WLL), mechanical lateral distal femoral angle (mLDFA), and medial proximal tibial angle (MPTA) were measured using teleroentgenogram. Lower limb deformity was defined as a difference of more than 5° in mLDFA or MPTA in both lower extremities or a difference in WLL of more than 1 cm. Patients were divided into two groups, with deformity and without deformity.
RESULTS
RESULTS
Lower extremity deformities were observed in 8 of 83 patients. Significant difference in the type of osteochondroma (p = 0.004) between the groups was observed. Differences in sex, age, laterality, involved bone, direction, and distance from the physis to the osteochondroma between groups were not statistically significant. The sessile type of osteochondroma was a risk factor for lower limb deformity with an odds ratio of 24.0 according to Firth's logistic regression analysis.
CONCLUSION
CONCLUSIONS
In our cohort with solitary osteochondroma, lower limb deformities were observed in 8 (9.6%) out of the 83 patients and these were significantly associated with sessile-type tumors. Therefore, patients with sessile-type solitary osteochondroma around the knee require careful surveillance of lower limb alignment with whole leg teleroentgenogram.
Identifiants
pubmed: 39030613
doi: 10.1186/s13018-024-04908-4
pii: 10.1186/s13018-024-04908-4
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
415Informations de copyright
© 2024. The Author(s).
Références
Tepelenis K, Papathanakos G, Kitsouli A, Troupis T, Barbouti A, Vlachos K, Kanavaros P, Kitsoulis P. Osteochondromas: an Updated Review of Epidemiology, Pathogenesis, Clinical Presentation, Radiological features and treatment options. Vivo. 2021;35:681–91.
doi: 10.21873/invivo.12308
Clement ND, Porter DE. Can deformity of the knee and longitudinal growth of the leg be predicted in patients with hereditary multiple exostoses? A cross-sectional study. Knee. 2014;21:299–303.
doi: 10.1016/j.knee.2012.10.029
pubmed: 23177660
Saglik Y, Altay M, Unal VS, Basarir K, Yildiz Y. Manifestations and management of osteochondromas: a retrospective analysis of 382 patients. Acta Orthop Belg. 2006;72:748–55.
pubmed: 17260614
Florez B, Monckeberg J, Castillo G, Beguiristain J. Solitary osteochondroma long-term follow-up. J Pediatr Orthop B. 2008;17:91–4.
doi: 10.1097/BPB.0b013e3282f450c3
pubmed: 18510166
Herget GW, Kontny U, Saueressig U, Baumhoer D, Hauschild O, Elger T, Sudkamp NP, Uhl M. [Osteochondroma and multiple osteochondromas: recommendations on the diagnostics and follow-up with special consideration to the occurrence of secondary chondrosarcoma]. Radiologe. 2013;53:1125–36.
doi: 10.1007/s00117-013-2571-9
pubmed: 24129968
Kim NT, Kwon SS, Choi KJ, Park MS, Chung JY, Han HS, Sung KH. Effect of Screw Configuration on the rate of correction for guided growth using the tension-band plate. J Pediatr Orthop. 2021;41:e899–903.
doi: 10.1097/BPO.0000000000001970
pubmed: 34534159
Jung HS, Park MS, Lee KM, Choi KJ, Choi WY, Sung KH. Growth arrest and its risk factors after physeal fracture of the distal tibia in children and adolescents. Injury. 2021;52:844–8.
doi: 10.1016/j.injury.2021.01.014
pubmed: 33526260
Lee KM, Lee J, Chung CY, Ahn S, Sung KH, Kim TW, Lee HJ, Park MS. Pitfalls and important issues in testing reliability using intraclass correlation coefficients in orthopaedic research. Clin Orthop Surg. 2012;4:149–55.
doi: 10.4055/cios.2012.4.2.149
pubmed: 22662301
pmcid: 3360188
Bonett DG. Sample size requirements for estimating intraclass correlations with desired precision. Stat Med. 2002;21:1331–5.
doi: 10.1002/sim.1108
pubmed: 12111881
Nawata K, Teshima R, Minamizaki T, Yamamoto K. Knee deformities in multiple hereditary exostoses. A longitudinal radiographic study. Clin Orthop Relat Res 1995:194–9.
Pierz KA, Stieber JR, Kusumi K, Dormans JP. Hereditary multiple exostoses: one center’s experience and review of etiology. Clin Orthop Relat Res 2002:49–59.
Ahn YS, Woo SH, Kang SJ, Jung ST. Coronal malalignment of lower legs depending on the locations of the exostoses in patients with multiple hereditary exostoses. BMC Musculoskelet Disord. 2019;20:564.
doi: 10.1186/s12891-019-2912-6
pubmed: 31766997
pmcid: 6878674
Porter DE, Emerton ME, Villanueva-Lopez F, Simpson AH. Clinical and radiographic analysis of osteochondromas and growth disturbance in hereditary multiple exostoses. J Pediatr Orthop. 2000;20:246–50.
doi: 10.1097/01241398-200003000-00022
pubmed: 10739291
Porter DE, Simpson AH. The neoplastic pathogenesis of solitary and multiple osteochondromas. J Pathol. 1999;188:119–25.
doi: 10.1002/(SICI)1096-9896(199906)188:2<119::AID-PATH321>3.0.CO;2-N
pubmed: 10398153
Carroll KL, Yandow SM, Ward K, Carey JC. Clinical correlation to genetic variations of hereditary multiple exostosis. J Pediatr Orthop. 1999;19:785–91.
doi: 10.1097/01241398-199911000-00017
pubmed: 10573350
Liu Y, Fang J, Liu Y, Zhang Z, Wang X, Guo Z, Zhang F. Potential influence of factors for genu valgus with hereditary multiple exostoses. J Pediatr Orthop B. 2022;31:365–70.
doi: 10.1097/BPB.0000000000000955
pubmed: 35170573
Pacifici M. The pathogenic roles of heparan sulfate deficiency in hereditary multiple exostoses. Matrix Biol. 2018;71–72:28–39.
doi: 10.1016/j.matbio.2017.12.011
pubmed: 29277722
Porter DE, Lonie L, Fraser M, Dobson-Stone C, Porter JR, Monaco AP, Simpson AH. Severity of disease and risk of malignant change in hereditary multiple exostoses. A genotype-phenotype study. J Bone Joint Surg Br. 2004;86:1041–6.
doi: 10.1302/0301-620X.86B7.14815
pubmed: 15446535
Clement ND, Duckworth AD, Baker AD, Porter DE. Skeletal growth patterns in hereditary multiple exostoses: a natural history. J Pediatr Orthop B. 2012;21:150–4.
doi: 10.1097/BPB.0b013e32834dd21f
pubmed: 22139142
Pacifici M. Hereditary multiple exostoses: New insights into Pathogenesis, Clinical complications, and potential treatments. Curr Osteoporos Rep. 2017;15:142–52.
doi: 10.1007/s11914-017-0355-2
pubmed: 28466453
pmcid: 5510481
Park H, Kim HW, Park KB, Kim JH, Chang WJ, Park BK. Effect of Solitary Osteochondroma on alignment and length in the Lower extremities. J Pediatr Orthop. 2024;4:e351–6.
doi: 10.1097/BPO.0000000000002612