Validation of central peak height method for final adult height predictions on long leg radiographs

Marco Brenneis; Niklas Thewes; Jana Holder; Felix Stief; Sebastian Braun

doi:10.1302/2633-1462.410.BJO-2023-0105.R1

Validation of central peak height method for final adult height predictions on long leg radiographs

Bone Jt Open. 2023 Oct 10;4(10):750-757. doi: 10.1302/2633-1462.410.BJO-2023-0105.R1.

Authors

Marco Brenneis¹, Niklas Thewes¹, Jana Holder^{1

2}, Felix Stief^{1

3}, Sebastian Braun^{1

4}

Affiliations

¹ Department of Orthopedics (Friedrichsheim), University Hospital, Goethe University Frankfurt, Frankfurt, Germany.
² Department of Sport and Exercise Science, University of Salzburg, Salzburg, Austria.
³ Dr. Rolf M. Schwiete Research Unit for Osteoarthritis, Department of Orthopedics (Friedrichsheim), University Hospital, Goethe University Frankfurt, Frankfurt, Germany.
⁴ Center for Musculoskeletal Surgery, Charité - University Hospital Berlin, Berlin, Germany.

PMID: 37813396
PMCID: PMC10562078
DOI: 10.1302/2633-1462.410.BJO-2023-0105.R1

Abstract

Aims: Accurate skeletal age and final adult height prediction methods in paediatric orthopaedics are crucial for determining optimal timing of growth-guiding interventions and minimizing complications in treatments of various conditions. This study aimed to evaluate the accuracy of final adult height predictions using the central peak height (CPH) method with long leg X-rays and four different multiplier tables.

Methods: This study included 31 patients who underwent temporary hemiepiphysiodesis for varus or valgus deformity of the leg between 2014 and 2020. The skeletal age at surgical intervention was evaluated using the CPH method with long leg radiographs. The true final adult height (FH_TRUE) was determined when the growth plates were closed. The final height prediction accuracy of four different multiplier tables (1. Bayley and Pinneau; 2. Paley et al; 3. Sanders - Greulich and Pyle (SGP); and 4. Sanders - peak height velocity (PHV)) was then compared using either skeletal age or chronological age.

Results: All final adult height predictions overestimated the FH_TRUE, with the SGP multiplier table having the lowest overestimation and lowest absolute deviation when using both chronological age and skeletal age. There were no significant differences in final height prediction accuracy between using skeletal age and chronological age with PHV (p = 0.652) or SGP multiplier tables (p = 0.969). Adult height predictions with chronological age and SGP (r = 0.769; p ≤ 0.001), as well as chronological age and PHV (r = 0.822; p ≤ 0.001), showed higher correlations with FH_TRUE than predictions with skeletal age and SGP (r = 0.657; p ≤ 0.001) or skeletal age and PHV (r = 0.707; p ≤ 0.001).

Conclusion: There was no significant improvement in adult height prediction accuracy when using the CPH method compared to chronological age alone. The study concludes that there is no advantage in routinely using the CPH method for skeletal age determination over the simple use of chronological age. The findings highlight the need for more accurate methods to predict final adult height in contemporary patient populations.