Epiphysiodesis Made with Radio Frequency Ablation: First Results From a Pilot Study

Anisomelia is a condition of leg length discrepancy. In children, it is often treated with epiphysiodesis of the growth plate. Current techniques involve opening cortical windows on both the lateral and medial sides of the bone. The growth plate is manually destroyed with curettes and/or drills. Complications such as breaching the anterior or posterior cortex of the treated bone have potentially serious consequences with risk of vascular and/ or nerve injury. Further damage to the metaphyseal region of the bone may be incurred through excessive curettage and drilling. Therefore, there is a need for a reliable and precise procedure which overcomes the complications.
Development of a new technique for epiphysiodesis using radiofrequency ablation on an animal model that involves less scarring, less exposure to X-rays, and reduces the risk of injuring the surrounding structures compared to current methods.
3 non-mature 40 kg 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. A probe was inserted and the ablation performed. MR images were performed right after the procedure and 12 weeks later.
The length of both tibiae was measured. Both legs were equal at the beginning of the study and there was a leg length difference of around 4mm at the end. No damage to the surrounding cartilage structures was found.
Epiphysiodesis using radio frequency ablation is an innovative technique that may represent an alternative way of treatment. These results show that it is possible to arrest growth using this technique but chronic studies must be performed in order to obtain more evidence of both the safety and effectiveness of the procedure.