ArticleJournal of the Pediatric Orthopaedic Society of North America2026
Failure to Follow-Up in 41% of MCGR Patients: A Multi-Center Analysis of Prolonged Intervals and Associated Institutional Resources.
Article in Journal of the Pediatric Orthopaedic Society of North America, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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9 authors.
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Abstract
Background: Magnetically controlled growing rods (MCGR) enable clinic-based distractions at prescribed intervals without surgery. No studies to date quantify failure-to-follow-up (FFU) for routine lengthenings or examine center-level characteristics associated with prolonged intervals. We hypothesize that an unrealized proportion of EOS patients will experience FFU and sought to define FFU rates across centers and explore site-level characteristics associated with FFU. Methods: A retrospective review of an international registry of EOS patients with at least 2 years of follow-up after implantation of MCGRs was conducted. FFU was predefined as >180 days between subsequent lengthenings, selected as a conservative, clinically meaningful threshold because routine MCGR distractions are typically performed more frequently (approximately every 2.5-3 months). Institutional variables not present in the base registry were obtained via a separate site-level questionnaire and analyzed among large-volume centers. Associations were interpreted as non-causal. Results: A median of 41% of patients experienced at least one FFU event, with frequency ranging from 0 to 80%. Three centers were determined to be outliers with a relatively high percent FFU (↑ FFU group), and two centers were high-performing outliers with a low FFU (↓ FFU group) rate. Centers that reported holding regular (≥monthly) spine research meetings demonstrated lower FFU rates, while other site-level variables showed mixed associations. Conclusions: FFU events were common in this multicenter cohort. Site-level characteristics showed associations with FFU frequency but do not imply causation. Future work should incorporate patient-level factors and prospective interval protocols to clarify determinants and outcomes of FFU. Key Concepts: (1)Over 40% of patients have at least one failure to follow-up event for magnetically controlled growing rod lengthening.(2)Institutional markers, such as research productivity, may be surrogates for infrastructural factors leading to increased failure to follow-up rates. Level of Evidence: III.
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