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Topic:

Blount's Disease

Issue:

Knee

Category:

Developmental

Title:

The Effect of Socioeconomic Deprivation on Radiographic Deformities in Children With Blount Disease

Author:

Benes, Gregory BS; Ghanem, Diane MD; Badin, Daniel MD; Greenberg, Marc MD; Honcharuk, Erin MD

Journal:

Journal of Pediatric Orthopaedics

Date:

April 2024

Reference:

44(4):p 254-259, DOI: 10.1097/BPO.0000000000002608

Level Of Evidence:

III

# of Patients:

65

Study Type:

Retrospective cohort study

Location:

Community-based cohort, United States

Summary:

Investigated the relationship between socioeconomic deprivation and the severity of lower extremity deformities in children with Blount disease. Patients were assessed for socioeconomic status using the area deprivation index (ADI) and for deformity using mechanical axis deviation and varus deformity measurements from full-length standing radiographs.

Methods:

Patients were classified as having early-onset (<4 years) or late-onset (≥4 years) Blount disease. ADI was calculated at both state (1–10) and national (1–100) levels. Radiographic measures included mechanical axis deviation and varus deformity. Statistical analyses included linear regression to control for demographic and socioeconomic factors.

Exclusions:

Not specified

Results:

Black patients had significantly higher ADI scores (state: 7.6 vs. 5.4, P=0.009; national: 55.1 vs. 37.4, P=0.002). Higher socioeconomic deprivation (ADI) was associated with greater mechanical axis deviation (66 mm vs. 51 mm, P=0.008). Multivariate analysis showed that increased body mass index (BMI) and state ADI were independently associated with more severe varus deformity.

Conclusions:

Socioeconomic deprivation and obesity are significant factors in the progression and severity of Blount disease. These findings highlight the need to address health disparities and early intervention in socioeconomically deprived populations to mitigate disease severity.

Relevance:

Limitations:

Perspective:

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