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Clinical Orthopaedics and Related Research®

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01-02-2012 | Clinical Research

Is Bilateral Lower Limb Lengthening Appropriate for Achondroplasia?: Midterm Analysis of the Complications and Quality of Life

Authors: Seung-Ju Kim, MD, Gracia Cielo Balce, MD, Mandar Vikas Agashe, MD, Sang-Heon Song, MD, Hae-Ryong Song, MD, PhD

Published in: Clinical Orthopaedics and Related Research® | Issue 2/2012

Abstract

Background

Use of the Ilizarov technique for limb lengthening in patients with achondroplasia is controversial, with a high risk of complications balancing cosmetic gains. Although several articles have described the complications of this procedure and satisfaction of patients after surgery, it remains unclear whether lengthening improves the quality of life (QOL) of these patients.

Questions/purposes

We asked whether bilateral lower limb lengthenings with deformity correction in patients with achondroplasia would improve QOL and investigated the correlation between complication rate and QOL.

Patients and Methods

We retrospectively reviewed 22 patients (average age, 12.7 years) diagnosed with achondroplasia who underwent bilateral lower limb lengthenings between 2002 and 2005. These patients were compared with 22 patients with achondroplasia for whom limb lengthening was not performed. The two groups were assessed using the American Academy of Orthopaedic Surgeons (AAOS) lower limb, SF-36, and Rosenberg self-esteem scores. Minimum followup was 4.5 years (range, 4.5–6.9 years).

Results

Among the lengthening group, the average gain in length was 10.21 ± 2.39 cm for the femur and 9.13 ± 2.12 cm for the tibia. A total of 123 complications occurred in these 88 segments. The surgical group had higher Rosenberg self-esteem scores than the nonsurgical group although there were no differences in the AAOS and the SF-36 scores. The self-esteem scores decreased with the increase in the number of complications.

Conclusions

Our data suggest that despite frequent complications, bilateral lower limb lengthening increases patients’ QOL. We believe lengthening is a reasonable option in selected patients.

Level of Evidence

Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

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Title: Is Bilateral Lower Limb Lengthening Appropriate for Achondroplasia?: Midterm Analysis of the Complications and Quality of Life
Authors: Seung-Ju Kim, MD
Gracia Cielo Balce, MD
Mandar Vikas Agashe, MD
Sang-Heon Song, MD
Hae-Ryong Song, MD, PhD
Publication date: 01-02-2012
Publisher: Springer-Verlag
Published in: Clinical Orthopaedics and Related Research® / Issue 2/2012
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI: https://doi.org/10.1007/s11999-011-1983-y

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Springer Medicine

Is Bilateral Lower Limb Lengthening Appropriate for Achondroplasia?: Midterm Analysis of the Complications and Quality of Life

Abstract

Background

Questions/purposes

Patients and Methods

Results

Conclusions

Level of Evidence

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Questions/purposes

Patients and Methods

Results

Conclusions

Level of Evidence

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