Abstract
Background
Techniques for epiphysiodesis have evolved from open surgical techniques requiring direct observation of the physis to percutaneous techniques performed with fluoroscopy.
Questions/purposes
Our purposes were to (1) describe a new minimally invasive surgical technique used to achieve epiphysiodesis using radiofrequency ablation, (2) document the effect of radiofrequency ablation on tibia length at 2, 6, and 12 weeks after ablation in a skeletally immature rabbit model, and (3) assess the effects of radiofrequency ablation on the histologic appearance of the proximal tibia physis and proximal tibia articular cartilage.
Materials and Methods
We performed epiphysiodesis of the rabbit proximal tibia on 15 skeletally immature male New Zealand White rabbits using a 22-gauge radiofrequency probe. The probe was positioned percutaneously and heated to 90°C for 4 minutes on the medial and lateral ½ of the physis. The opposite tibia was used as a control. Five animals were sacrificed at 2, 6, or 12 weeks postoperatively. Tibia length was compared using Faxitron® radiographs and electronic calipers. Histology of the growth plate was assessed with light microscopy.
Results
We observed differences in tibia length between 4.16 mm and 11.59 mm (average 7.86 mm) at 12 weeks. The proximal tibia physis closed radiographically and histologically in all animals by 12 weeks. Histologic analysis showed no evidence of articular cartilage injury.
Conclusions
This technique was reproducible and resulted in bone fusion of the rabbit proximal tibial growth plate. The use of radiofrequency ablation as described in this report may be used as an alternative to other surgical epiphysiodesis techniques.
Clinical Relevance
This technique may be useful for epiphysiodesis of small tubular bones of the hands and feet in humans.
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Acknowledgments
We thank John Denneen for help in performing all aspects of this study.
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Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.
Each author certifies that his or her institution approved the animal protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.
This work was performed at the Hospital for Special Surgery.
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Widmann, R.F., Amaral, T.D., Yildiz, C. et al. Percutaneous Radiofrequency Epiphysiodesis in a Rabbit Model: A Pilot Study. Clin Orthop Relat Res 468, 1943–1948 (2010). https://doi.org/10.1007/s11999-010-1286-8
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DOI: https://doi.org/10.1007/s11999-010-1286-8