The challenges in most Adolescent Blount’s Disease cases are that the patients are often quite large both in weight and in height. While obesity plays a role in Blount’s disease at all ages, it especially plays a role in the adolescent group. The best way to think of the adolescent group is that it is a partial growth arrest of the upper tibia. Since there is limited growth remaining in the upper tibia (6 mm per year), it is often easier to do an osteotomy, close the upper tibial growth plate, and lengthen the leg. In bilateral cases, it is just as easy to close both upper tibial growth plates; therefore, lengthening is not required.