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Study Sheds Light on TBP-Guided Hemiepiphysiodesis in Blount Disease

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Blount disease, a growth disorder of the tibia characterized by bowing of the lower leg that worsens over time, is corrected surgically, typically using tension band plate (TBP)-guided hemiepiphysiodesis. Because many studies have reported high failure rates with this procedure in patients with Blount disease, a 10-year, single-institution, retrospective chart-review assessing the surgical failure rate in patients treated with this procedure was conducted to better characterize predictors for failure. The study revealed the following:

  • A 41% overall surgical failure rate (range in other studies, 11%-100%) and an 11% mechanical failure rate (range in other studies, 0%-50%).
  • Univariate analysis showed severity of deformity, plate material, and obesity to be risk factors for surgical failure.
  • Multivariate analysis after individual risk-factor adjustment showed the odds of surgical failure to increase 1.2 times with severe deformity and 5.9 times with use of titanium TBP.
  • All mechanical failures involved breakage of cannulated screws on the metaphyseal side.

Based on their findings, the investigators concluded that “efficacy of TBP still needs to be proven in Blount disease and implant design may warrant reassessment.”

Read more here.


Jain MJ, Inneh IA, Zhu H, et al. Tension band plate (TBP)-guided hemiepiphysiodesis in Blount disease: 10-year single-center experience with a systematic review of literature. J Pediatr Orthop. 2019 Apr 23. doi: 10.1097/BPO.0000000000001393.

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