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Arthroscopy-assisted physeal bar resection restores knee motion in toddlerArthroscopy and Imaging Help Treat Tibial Physeal Bar Lesions

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Key Takeaway
Consider arthroscopy-assisted resection with C-arm imaging for physeal bars, but evidence is limited to a single case.

This publication is a case report combined with a narrative review, focusing on the surgical management of physeal bars in pediatric patients. The case involves a 2-year-old female with a proximal tibial physeal bar resulting from a neonatal infection, leading to limb length discrepancy and varus knee deformity. The intervention was physeal bar resection assisted by arthroscopy and intraoperative C-arm imaging. The primary outcome was removal of the lesion without resecting healthy physeal cartilage, which was achieved. Secondary outcomes included restored range of knee motion and full symptom resolution. The authors highlight the clinical value of integrating arthroscopy with C-arm imaging for precise, minimally invasive resection. Limitations include the single-case design and narrative review format, meaning results are not generalizable. No adverse events, follow-up duration, or funding details were reported. While the technique shows promise, cautious interpretation is warranted due to the lack of comparative data and small sample size.

Doctors reported on a case involving a two-year-old girl who had a proximal tibial physeal bar. This condition was caused by an infection she had as a newborn. The issue led to a limb length discrepancy and a varus knee deformity, which can affect how a child moves and grows.

The surgical team used a combination of arthroscopy and intraoperative C-arm imaging to treat the area. This method allowed them to remove the specific lesion while avoiding the removal of healthy physeal cartilage. The goal was to preserve as much healthy tissue as possible during the procedure.

Following the surgery, the child experienced a full resolution of symptoms and regained her range of motion in the knee. Because this is a single case report and narrative review, these results are not yet proven for all children with similar conditions. It shows a promising way to use specific imaging tools to improve surgical accuracy.

What this means for you:
Combining arthroscopy and C-arm imaging may help surgeons remove bone lesions while protecting healthy cartilage.

Common questions

What is a physeal bar?

A physeal bar is a type of lesion that can develop in the growth plate of a bone. In this specific case, it was caused by a neonatal infection and led to issues like limb length discrepancy and varus knee deformity in a two-year-old child.

How did the surgery help the patient?

The use of arthroscopy and C-arm imaging allowed for the safe removal of the lesion. This specific technique helped avoid cutting into healthy cartilage, which resulted in the child regaining her full range of motion and a full resolution of symptoms.

Is this treatment available for everyone with these conditions?

Because this finding comes from a single case report and narrative review, it is not yet known if this method works for every patient. You should speak with a specialist to see how these specific surgical tools might apply to your situation.

Study Details

Study typeSystematic review
EvidenceLevel 1
PublishedJul 2026
View Original Abstract ↓
The formation of physeal bars following growth plate injuries can cause complications such as limb length discrepancies and angular or physeal deformities. Physeal bars usually form after fractures but can also develop due to infectious processes. Management strategies depend on factors such as the bar's location, extent and residual growth potential. We describe the case of a two-year-old female with a lower limb discrepancy and a slight varus knee deformity caused by a proximal tibial physeal bar due to a neonatal infection. The severe anatomical epiphyseal anomaly of her right proximal tibia had developed into a consistent joint irregularity. At 26 months old, the patient underwent a physeal bar resection, assisted by arthroscopy and intraoperative C-arm imaging. This minimally invasive technique facilitated safe, accurate removal of the lesion, avoiding any resection of healthy physeal cartilage. Postoperative outcomes were favourable, including restored range of knee motion and full symptom resolution. This approach demonstrated the clinical value of integrating arthroscopy equipment assistance with intraoperative C-arm imaging during the surgical treatment of physeal bars.
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