169.
Thermal Epiphysiodesis Made with Radio Frequency Ablation: An
Alternative Treatment for Leg Length Discrepancy
Juan Manuel Shiguetomi-Medina, Ole Rahbek, Hans Stødkilde-Jørgensen,
Bjarne Møller-Madsen
Children's Orthopaedic Department E Aarhus University Hospital NBG;
Children's Orthopaedic Department E, Aarhus University Hospital NBG; The
MR Research Center, Aarhus University Hospital Skejby; Children´s
Orthopaedic Department E, Aarhus University Hospital NBG
Background:
Anisomelia is a condition of leg length discrepancy. It is often
treated with epiphysiodesis of the growth plate to inhibit growth.
Epiphysiodesis has become the most commonly used procedure for leg length
equalization. Current techniques may injure the surrounding structures.
Therefore, there is a need for a reliable, precise procedure which overcomes
the complications.
Purpose / Aim of Study:
Development of a new technique for epiphysiodesis
using radiofrequency ablation in an experimental porcine model.
Materials and Methods:
Six 35kg pigs and two 25kg non-mature pigs were
used. A control leg was randomly selected and the contralateral treated at two
ablation sites (lateral and medial) identified at the proximal tibia growth plate
using x-ray. Under general anesthesia, a probe was inserted and the ablation
performed. T1, T2 and water content MR images were performed right after
the procedure, 12 weeks later for 6 animals, and 6 months later for the last 2
ones. The length of both tibiae was measured immediately after the ablation
and at the end of the study.
Findings / Results:
Both legs were equal at the beginning of the study and,
overall, there was an average leg length difference (P=0.006) of 4.8mm
(
SD=2.25, Median=3.88) at the end. For the 12 week follow-up we found an
average leg length difference of 3.9mm (SD=1.286, Median=3.666, P=0.014),
and for the 6 month one we found an average difference of 8.11mm. No
damage to the surrounding cartilage structures was found.
Conclusions:
Epiphysiodesis using radio frequency ablation is an innovative
technique that may represent an alternative way of treatment that potentially
involves less scarring, less exposure to X-rays, and reduces the risk of injuring
the surrounding structures compared to current methods. These results show
that this technique can arrest growth in a safe and effective way.
