Guided Growth as a Component of Joint-Preserving Management of Complex Osteoarticular Pathology in the Growing Knee: A Pediatric Case Report
- 1Department of Orthopedic Surgery, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, 20 Geumo-ro, Mulgeum-eup, Yangsan-si 50612, Gyeongsangnam-do, Republic of Korea; (K.B.K.); (J.M.C.); (W.C.S.); (M.U.D.); (J.Y.B.)
- 2Department of Orthopedic Surgery, College of Medicine, Dong-A University, Busan 49201, Republic of Korea;
Abstract
Background/Objectives: Valgus alignment shifts load toward the lateral compartment, and even a mild shift may matter when that compartment already contains a torn meniscus and an osteochondral lesion. We describe a skeletally immature knee in which a torn discoid lateral meniscus (DLM), an osteochondral lesion of the lateral femoral condyle and mild valgus coexisted. Case Presentation: A 14-year-old boy presented with longstanding right knee pain, lateral joint line tenderness and a positive McMurray test. The hip–knee–ankle (HKA) axis showed 4° of valgus (contralateral 0.5°), with a mechanical lateral distal femoral angle (mLDFA) of 84.6°, a medial proximal tibial angle (mMPTA) of 90.0° and mechanical axis deviation (MAD) 10.78 mm lateral. Imaging and arthroscopy showed a torn, centrally shifted DLM and a 1.4 × 1.6 cm ICRS grade 4 lesion of the lateral femoral condyle. Saucerization with repair, microfracture, and temporary hemiepiphysiodesis of the medial distal femoral and proximal tibial physes were performed in one stage. Results: At five months, the HKA was 0.7° varus (mLDFA, 87.2°; mMPTA, 88.3°) and the screws were removed; the repaired meniscus measured 9 mm in width without extrusion. At two years, the HKA was neutral (mLDFA, 87.0°; mMPTA, 87.7°; MAD, 0 mm) without rebound, and the patient was asymptomatic; no validated patient-reported outcome measure was collected. Conclusions: As a short-term result in a single patient, this case illustrates the feasibility of incorporating temporary hemiepiphysiodesis into a joint-preserving strategy in a selected skeletally immature knee. It is not evidence of efficacy; longer-term follow-up is needed to judge joint preservation.
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BibTeX
@article{kim2026guided,
title = {{Guided Growth as a Component of Joint-Preserving Management of Complex Osteoarticular Pathology in the Growing Knee: A Pediatric Case Report}},
author = {Kyeong Baek Kim and Jung Shin Kim and Jae Min Cho and Won Chul Shin and Min Uk Do and Jung Yun Bae and Sang-Min Lee},
journal = {Children (Basel, Switzerland)},
year = {2026},
month = sep,
doi = {10.3390/children13101312},
url = {https://europepmc.org/article/PMC/PMC13703123},
note = {CC BY},
}
RIS
TY - JOUR
TI - Guided Growth as a Component of Joint-Preserving Management of Complex Osteoarticular Pathology in the Growing Knee: A Pediatric Case Report
AU - Kyeong Baek Kim
AU - Jung Shin Kim
AU - Jae Min Cho
AU - Won Chul Shin
AU - Min Uk Do
AU - Jung Yun Bae
AU - Sang-Min Lee
PY - 2026
DA - 2026/09/01
JO - Children (Basel, Switzerland)
DO - 10.3390/children13101312
UR - https://europepmc.org/article/PMC/PMC13703123
AB - Background/Objectives: Valgus alignment shifts load toward the lateral compartment, and even a mild shift may matter when that compartment already contains a torn meniscus and an osteochondral lesion. We describe a skeletally immature knee in which a torn discoid lateral meniscus (DLM), an osteochondral lesion of the lateral femoral condyle and mild valgus coexisted. Case Presentation: A 14-year-old boy presented with longstanding right knee pain, lateral joint line tenderness and a positive McMurray test. The hip–knee–ankle (HKA) axis showed 4° of valgus (contralateral 0.5°), with a mechanical lateral distal femoral angle (mLDFA) of 84.6°, a medial proximal tibial angle (mMPTA) of 90.0° and mechanical axis deviation (MAD) 10.78 mm lateral. Imaging and arthroscopy showed a torn, centrally shifted DLM and a 1.4 × 1.6 cm ICRS grade 4 lesion of the lateral femoral condyle. Saucerization with repair, microfracture, and temporary hemiepiphysiodesis of the medial distal femoral and proximal tibial physes were performed in one stage. Results: At five months, the HKA was 0.7° varus (mLDFA, 87.2°; mMPTA, 88.3°) and the screws were removed; the repaired meniscus measured 9 mm in width without extrusion. At two years, the HKA was neutral (mLDFA, 87.0°; mMPTA, 87.7°; MAD, 0 mm) without rebound, and the patient was asymptomatic; no validated patient-reported outcome measure was collected. Conclusions: As a short-term result in a single patient, this case illustrates the feasibility of incorporating temporary hemiepiphysiodesis into a joint-preserving strategy in a selected skeletally immature knee. It is not evidence of efficacy; longer-term follow-up is needed to judge joint preservation.
SN - 2227-9067
ER -