Pediatric V-VAS™ KAFO Case Studies: Blount's Disease Treatment Outcomes

Clinical Summary: Two independently authored case studies of the Pediatric V-Vas™ KAFO (VVASBK) show improved compliance and continued skeletal realignment compared with traditional locked-knee bracing, and support its use alongside surgical hemiepiphysiodesis in patients with documented risk factors for correction failure.

Why compliance and correction both matter in Blount's disease

Non-surgical bracing has long been a first-line option for infantile Blount's disease, but traditional locked-knee KAFOs carry a well-documented compliance problem: the altered, stiff-legged gait pattern they impose often leads children and caregivers to reduce wear time, which in turn allows the deformity to progress. For patients with risk factors such as obesity, bilateral involvement, or an older age at bracing onset, that combination of reduced compliance and higher baseline risk can push families toward surgery sooner than might otherwise be needed. A brace design that preserves more natural knee motion while still generating an effective corrective force addresses the compliance side of that equation directly.

About the Pediatric V-Vas™ KAFO

The Pediatric V-Vas™ KAFO uses a double-upright, free-motion knee joint that can isolate tibial and femoral alignment independently, in fixed-degree increments, rather than relying on a single locked hinge position. Medial and lateral Tamarack® ankle joints allow relative dorsiflexion and plantarflexion while maintaining mediolateral ankle stability, and posterior-opening polypropylene cuffs with removable, washable liners simplify donning and doffing for families managing daily wear. The design is intended to maintain corrective bending moments throughout the child's range of knee motion, not only when the knee is fully extended.

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What the clinical evidence shows

Two case studies — a comparison against traditional locked-knee bracing, and a postoperative case alongside surgical correction — point to two related conclusions: the free-motion design may support better long-term adherence, and it can complement surgery in higher-risk patients.

Compliance and correction

In a comparison of two children with Blount's disease, one who did not sustain correction with a traditional locked double-upright KAFO went on to show steady radiographic improvement after switching to the free-motion V-Vas KAFO.

Postoperative support

In a patient with documented risk factors for hemiepiphysiodesis failure, an offloading V-Vas KAFO worn alongside surgery was associated with continued improvement in varus alignment, from 23° preoperatively to 11° at sixteen months.

Featured Studies

Improved Outcomes Using a New Free Motion KAFO for Treatment of Blounts Disease vs. Traditional Locked Knee Designs

Whiteside JW, CO/LO

Whiteside JW. Improved Outcomes Using a New Free Motion KAFO for Treatment of Blounts Disease vs. Traditional Locked Knee Designs. Anatomical Concepts, Inc.

This case comparison follows two children treated for Blount's disease, contrasting a traditional double solid-upright locked-knee KAFO with the free-motion V-Vas™ Blounts KAFO (VVASBK). The first patient, an obese male, was initially fitted with a locked-knee design; over roughly two years of care, the deformity repeatedly progressed between visits, which the treating team attributed to inconsistent wear. After switching to the VVASBK, follow-up radiographs at six months and again around a year later showed sustained improvement in tibial alignment that the earlier design had not achieved. The second patient was fitted with the VVASBK from the start of treatment and continued to show improved, age-appropriate alignment through nineteen months of follow-up, including after a planned break from bracing. The author, an orthotist with 25 years of experience managing Blount's disease patients, suggests the joint's independent tibial/femoral adjustability and easier donning may support better adherence than fixed-knee alternatives — including in obese and bilateral cases that have not traditionally been considered good candidates for orthotic management.

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Preliminary Outcome Using a New Free Motion Offloading KAFO for Postoperative Management of Hemiepiphysiodesis in Adolescent Tibia Vara

Whiteside JW, CO/LO

Whiteside JW. Preliminary Outcome Using a New Free Motion Offloading KAFO for Postoperative Management of Hemiepiphysiodesis in Adolescent Tibia Vara. Anatomical Concepts, Inc.

This case study asks whether adding an offloading KAFO to surgical hemiepiphysiodesis improves outcomes in a patient with documented risk factors for correction failure. The patient, a 10-year-old girl with adolescent tibia vara, presented with a mechanical axis deviation of 67mm and a medial proximal tibial angle of 70°, both associated with a higher likelihood that hemiepiphysiodesis alone would not fully correct the deformity. Following combined lateral and medial tibial hemiepiphysiodesis, the surgical and orthotic team fitted her with a V-Vas™ offloading KAFO to help counter residual varus thrust during gait, choosing a KAFO over a knee-only orthosis to address the external rotary forces seen during ambulation. Serial radiographs taken over sixteen months of combined treatment showed a steady decrease in the medial downward slope of the tibial plateau and an improvement in varus alignment from 23° preoperatively to 11°. The author suggests the orthosis's ability to isolate tibial and femoral correction independently may help sustain surgical correction in patients whose risk profile predicts a less predictable result from hemiepiphysiodesis alone.

Download the full paper (PDF) →

Frequently Asked Questions

What is Blount's disease?

Blount's disease is a growth disorder that causes bowing of the legs due to abnormal development of the tibia in children.

What is a Pediatric V-Vas™ KAFO and how is it different from a traditional Blount's disease brace?

The Pediatric V-Vas™ KAFO is a free-motion, double-upright knee-ankle-foot orthosis for Blount's disease. Unlike traditional locked-knee braces, which hold the knee rigid in extension, its joint system allows independent adjustment of tibial and femoral alignment and maintains a corrective bending moment throughout the child's knee motion. In one case comparison (Whiteside, Anatomical Concepts, Inc.), a patient who repeatedly lost correction with a traditional locked double-upright KAFO over roughly two years of care went on to show sustained radiographic improvement at six months and again around a year later after switching to the free-motion design.

When is surgery needed for Blount's disease?

Surgery may be required in more advanced cases when orthotic treatment is no longer effective.

Can a KAFO be worn together with hemiepiphysiodesis surgery?

Yes. In a case study of postoperative management following hemiepiphysiodesis (Whiteside, Anatomical Concepts, Inc.), a 10-year-old patient with two documented risk factors for surgical failure — a 67mm mechanical axis deviation and a 70° medial proximal tibial angle — was fitted with an offloading V-Vas™ KAFO after combined lateral and medial tibial hemiepiphysiodesis. Serial radiographs over sixteen months of combined treatment showed varus alignment improve from 23° preoperatively to 11°.

What age is orthotic treatment most effective for Blount's disease?

Published case data on the V-Vas™ KAFO covers a range of presentations, from an obese pediatric patient managed non-surgically over roughly two years to a 10-year-old with adolescent tibia vara treated alongside surgical hemiepiphysiodesis. Outcomes vary by age, deformity stage, and whether surgery is also involved, so a pediatric orthopedic evaluation is needed to determine the right approach for a specific child.

Is a Blount's disease brace still an option for children who are obese or have bilateral involvement?

Obesity and bilateral involvement have historically been considered less favorable for orthotic management. In one published case (Whiteside, Anatomical Concepts, Inc.), an obese male patient who repeatedly lost correction with a traditional locked-knee KAFO over roughly two years of care achieved sustained tibial alignment improvement after switching to the free-motion V-Vas™ KAFO design — suggesting the design may extend orthotic options for some patients previously steered toward surgery sooner.

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Pediatric KAFO Case Study | Blount's Disease Treatment