title: Determining the best treatment for coronal angular deformity of the knee joint in growing children: a decision analysis.
abstract: This study aimed to determine the best treatment modality for coronal angular deformity of the knee joint in growing children using decision analysis. A decision tree was created to evaluate 3 treatment modalities for coronal angular deformity in growing children: temporary hemiepiphysiodesis using staples, percutaneous screws, or a tension band plate. A decision analysis model was constructed containing the final outcome score, probability of metal failure, and incomplete correction of deformity. The final outcome was defined as health-related quality of life and was used as a utility in the decision tree. The probabilities associated with each case were obtained by literature review, and health-related quality of life was evaluated by a questionnaire completed by 25 pediatric orthopedic experts. Our decision analysis model favored temporary hemiepiphysiodesis using a tension band plate over temporary hemiepiphysiodesis using percutaneous screws or stapling, with utilities of 0.969, 0.957, and 0.962, respectively. One-way sensitivity analysis showed that hemiepiphysiodesis using a tension band plate was better than temporary hemiepiphysiodesis using percutaneous screws, when the overall complication rate of hemiepiphysiodesis using a tension band plate was lower than 15.7%. Two-way sensitivity analysis showed that hemiepiphysiodesis using a tension band plate was more beneficial than temporary hemiepiphysiodesis using percutaneous screws.
authors.affiliation: Department of Orthopaedic Surgery, Myongji Hospital, 55 Hwasu-ro, 14 Beon-gil, Deokyang-gu, Goyang, Kyungki 412-826, Republic of Korea.
authors.forename: Ki Hyuk
authors.initials: KH
authors.lastname: Sung
authors.affiliation: Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, 300 Gumi-Dong, Bundang-gu, Sungnam, Kyungki 463-707, Republic of Korea.
authors.forename: Chin Youb
authors.initials: CY
authors.lastname: Chung
authors.affiliation: Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, 300 Gumi-Dong, Bundang-gu, Sungnam, Kyungki 463-707, Republic of Korea.
authors.forename: Kyoung Min
authors.initials: KM
authors.lastname: Lee
authors.affiliation: Department of Orthopaedic Surgery, Myongji Hospital, 55 Hwasu-ro, 14 Beon-gil, Deokyang-gu, Goyang, Kyungki 412-826, Republic of Korea.
authors.forename: Seung Yeol
authors.initials: SY
authors.lastname: Lee
authors.affiliation: Department of Orthopaedic Surgery, Seoul National University Children's Hospital, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Republic of Korea.
authors.forename: In Ho
authors.initials: IH
authors.lastname: Choi
authors.affiliation: Department of Orthopaedic Surgery, Seoul National University Children's Hospital, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Republic of Korea.
authors.forename: Tae-Joon
authors.initials: TJ
authors.lastname: Cho
authors.affiliation: Department of Orthopaedic Surgery, Seoul National University Children's Hospital, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Republic of Korea.
authors.forename: Won Joon
authors.initials: WJ
authors.lastname: Yoo
authors.affiliation: Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, 300 Gumi-Dong, Bundang-gu, Sungnam, Kyungki 463-707, Republic of Korea.
authors.forename: Moon Seok
authors.initials: MS
authors.lastname: Park
mesh_terms: D002648:Child; D003661:Decision Support Techniques; D004838:Epiphyses / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology* / Q000601:surgery*; D019637:Orthopedic Procedures / Q000009:adverse effects; D011183:Postoperative Complications / Q000209:etiology; D011336:Probability