Review
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. May 18, 2022; 13(5): 427-443
Published online May 18, 2022. doi: 10.5312/wjo.v13.i5.427
Coronal plane deformity around the knee in the skeletally immature population: A review of principles of evaluation and treatment
Valentino Coppa, Mario Marinelli, Roberto Procaccini, Danya Falcioni, Luca Farinelli, Antonio Gigante
Valentino Coppa, Mario Marinelli, Roberto Procaccini, Danya Falcioni, Luca Farinelli, Antonio Gigante, Clinical Orthopaedics, Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Ancona 60121, Italy
Author contributions: Coppa V and Gigante A wrote the paper; Marinelli M, Procaccini R, Falcioni D and Farinelli L collected the data.
Conflict-of-interest statement: Authors declare they have not conflict of interests.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Antonio Gigante, MD, Full Professor, Clinical Orthopaedics, Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Via Tronto 10/A, Ancona 60121, Italy. scienza.clinortop@gmail.com
Received: February 25, 2021
Peer-review started: February 25, 2021
First decision: July 28, 2021
Revised: October 2, 2021
Accepted: April 8, 2022
Article in press: April 8, 2022
Published online: May 18, 2022
Core Tip

Core Tip: Physiological angulation requires no treatment other than clinical observation. If the clinical picture is doubtful, a long-standing X-ray of the lower limb is required for clarification. Once a pathological alignment is determined by X-ray, a differential diagnosis is needed to establish whether the deformity is idiopathic or a secondary condition. Furthermore, any associated deformities in other planes (e.g., rotation or length difference) should be evaluated. Pathological alignment should be treated for at least two reasons: To interrupt the vicious circle described by the Hueter-Volkmann law and to prevent premature degeneration of the joint. Both of these conditions stem from abnormal load distribution. Guided growth should be considered every time a coronal deformity of the knee is foreseen in a skeletally immature patient. Although comparative studies are lacking in the literature, this technique has a high success rate with few complications and a low impact on the patient and the family.