Guided Growth with Screws and Nonabsorbable Suture for Correcting Knee Flexion in Arthrogryposis for Preschool Population: Preliminary Report

Objective: To introduce an epiphysiodesis technique utilizing screws and nonabsorbable sutures, aimed at rectifying knee flexion contractures (KFCs) in arthrogryposis. Background: Arthrogryposis, a congenital condition characterized by joint contractures, often presents with knee flexion involvement, impeding ambulation. Conservative methods such as casting and physiotherapy may be insufficient, necessitating surgical intervention. Anterior epiphysiodesis emerges as a viable option, with various techniques described in the literature. Materials and Methods: Eight knees in 4 patients with arthrogryposis and KFCs underwent anterior femoral epiphysiodesis using screws and nonabsorbable sutures. Pre and postoperative measurements of KFC and distal femoral diaphyseal-epiphyseal angle were analyzed using the Mann-Whitney U test. Results: The procedure significantly improved KFCs, with a median final flexion angle of 0 degrees achieved postoperatively. The distal femoral diaphyseal-epiphyseal angle also increased significantly postoperatively. The average time for angular modification was 11.75 months. Long-Term complications were minimal Conclusion: KFCs pose functional challenges, particularly in arthrogryposis. Traditional interventions may not suffice, necessitating surgical approaches like anterior epiphysiodesis. This technique offers early correction with minimal invasiveness, good tolerability, and reversibility; particularly beneficial for younger patients. Anterior epiphysiodesis with screws and non-Absorbable sutures effectively corrects KFCs in arthrogryposis, offering a valuable alternative to more invasive procedures. It can achieve good results at a lower cost and with few complications, making it a valuable surgical option for younger patients.