Systematic Review of the Effectiveness of Transphyseal Screws for Correction of Coronal Plane Knee Deformities and Meta-analysis of Comparative Studies With Tension Band Plates.
Rajul Gupta, Aakanksha Sriwastwa, Diane Low et al.
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In 30 seconds
This systematic review and meta-analysis compared percutaneous epiphysiodesis using transphyseal screws (PETS) with tension band plates (TBP) for guided growth correction of coronal-plane knee deformities in skeletally immature patients. Thirteen studies were included, five comparative. PETS correction rates ranged from 0.64 to 1.3 degrees/month for mLDFA, 0.52 to 0.86 degrees/month for MPTA, and 1.3 to 3 mm/month for MAD. Comparative analyses favoured faster correction with PETS, but differences were not statistically significant; for mLDFA, θ=0.71; P =0.05.
Key findings
- PETS correction rates ranged from 0.64 to 1.3 degrees/month for mLDFA, 0.52 to 0.86 degrees/month for MPTA, and 1.3 to 3 mm/month for MAD.
- Compared with TBP, PETS showed faster correction for mLDFA (θ=0.71; P =0.05), MPTA (θ=0.60; P =0.06), and MAD (θ=0.80; P =0.11), without statistically significant differences.
- In idiopathic patients, comparative analyses did not show significant differences in mLDFA (θ=0.43; P =0.17) or MPTA (θ=0.6; P =0.06) correction speed.
Why it matters
Guided growth is used to address coronal-plane knee deformity in skeletally immature patients, and implant choice may affect correction speed. This review suggests PETS can achieve correction and may be faster than TBP, but the comparative evidence does not establish a significant advantage. The findings help frame the uncertainty clinicians face when considering these techniques.
What to keep in mind
The review included only five comparative studies, and the authors note heterogeneity among included studies. The comparative differences were not statistically significant.