Hemiepiphysiodesis: when should it be considered a day-case procedure?

Journal of Pediatric Orthopedics. Part B
Matthew C BarrettManoj Ramachandran

Abstract

Hemiepiphysiodesis is usually planned as a day-case but patients may stay overnight for pain control. In this study, we assessed the required level of analgesia (LOA) and length of stay (LOS) in patients undergoing hemiepiphysiodesis about the knee joint. We conducted a retrospective cohort study of patients that underwent temporary hemiepiphysiodesis of the distal femur or proximal tibia using hemiepiphysiodesis plates (eight-plates) for coronal plane deformities between January 2012 and October 2019. Demographics, type of procedure, anatomical site, anaesthetic time, preoperative, intraoperative and postoperative analgesia, and time of surgery were collected. Anterior hemiepiphysiodesis and permanent drill epiphysiodesis procedures were excluded. In this series of 79 patients, those with increased American Society of Anesthesiologists Score >1 and patients that were operated on >2 sites required increased LOA, (P < 0.05) and prolonged LOS (P < 0.05). The timing of surgery (morning vs. afternoon list) did not influence LOS or LOA. Patient-controlled analgesia (PCA) was required in 8 of 14 (57%) patients with four growth plates operated on. All (n = 12) patients that received PCA remained in hospital for at least one night. The...Continue Reading

References

Apr 7, 2007·Journal of Pediatric Orthopedics·Peter M Stevens
Jul 2, 2009·Journal of Pediatric Orthopedics·John M WiemannElizabeth A Szalay
Aug 23, 2016·Journal of Pediatric Orthopedics·Marina R MakarovJohn G Birch
Apr 17, 2018·Journal of Orthopaedics·Sanjay Kumar, S V Sonanis
Nov 20, 2018·Journal of Clinical Orthopaedics and Trauma·Raju VaishyaVipul Vijay
Apr 20, 2019·Orthopaedics & Traumatology, Surgery & Research : OTSR·Gino MartínezFelipe Hodgson

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