Percutaneous Epiphyseodesis

Gabriel, Keith R.; Crawford, Alvin H.; Roy, Dennis R.; True, M Scott; Sauntry, Sara

doi:10.1097/01241398-199405000-00016

Cited by 63 publications

(30 citation statements)

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“…The advantages of the percutaneous surgical techniques are obvious, including smaller incisions and shorter recovery. The disadvantages of percutaneous drill epiphysiodesis include the need for postoperative immobilization and delayed return to full activity, occasional postoperative joint effusion [5,6,15], and the potential for temporal delay in achieving the true epiphysiodesis effect [4,7,19,20]. The disadvantage of the percutaneous transphyseal screw technique is the need for implant removal at the completion of skeletal growth [9,11].…”

Section: Discussionmentioning

confidence: 99%

“…In most patients undergoing percutaneous ablative epiphysiodesis, surgeons recommend protected weightbearing between 1 and 6 weeks postoperatively and restriction from return to athletics for variable lengths of time. Concerns have been raised regarding fracture risk and risk of intraarticular drill penetration with this technique [5,9]. Percutaneous epiphysiodesis using transphyseal screws has several advantages over percutaneous drill epiphysiodesis: immediate full weightbearing postoperatively, less risk of joint penetration, and immediate effect on cessation of longitudinal growth [9,11].…”

Section: Introductionmentioning

confidence: 99%

“…Radiographic obliteration of the physis and subsequent limb-length equalization have been used with these percutaneous ablative surgical techniques [1, 5-7, 13, 15, 20]. Surgical complications have included failure of growth arrest [4,20], incomplete growth arrest with angular deformity [7,9,20], and postoperative knee effusion [5,6,15]. In most patients undergoing percutaneous ablative epiphysiodesis, surgeons recommend protected weightbearing between 1 and 6 weeks postoperatively and restriction from return to athletics for variable lengths of time.…”

Section: Introductionmentioning

confidence: 99%

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Percutaneous Radiofrequency Epiphysiodesis in a Rabbit Model: A Pilot Study

Widmann

Amaral

Yıldız

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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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 1 .

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Percutaneous Radiofrequency Epiphysiodesis in a Rabbit Model: A Pilot Study

Widmann

Amaral

Yıldız

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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“…In the original description of percutaneous epiphysiodesis, a double-portal approach was used [5]. A single-portal approach for percutaneous epiphysiodesis is described for the femur as well as the tibia [6,7]. Complication rates are found to be higher in the single-portal techniques, whereas the increase of complications is mainly ascribed to crossing of the midline in single-portal techniques [6].…”

Section: Discussionmentioning

confidence: 99%

“…The ablation is done from the medial and the lateral sides of the physis. In the original description of percutaneous epiphysiodesis, a double-portal approach was used [5]; however, a single-portal approach for percutaneous epiphysiodesis is described for the femur as well as the tibia [6,7]. Complications reported for single-portal approach epiphysiodesis are mainly associated with the femoral site.…”

Section: Introductionmentioning

confidence: 99%

Percutaneous epiphysiodesis in the proximal tibia by a single-portal approach: Evaluation by radiostereometric analysis

Horn

Gunderson

Wensaas

et al. 2013

Journal of Children's Orthopaedics

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Purpose We modified the method for tibial epiphysiodesis by solely using a lateral approach to the physis. From this small-incision approach, the lateral as well as the medial part of the tibial physis were ablated. The aim of our study was to see if this operative technique might be as effective as a bilateral approach, and reduce the operation time and usage time of the image intensifier. The epiphysiodeses were monitored by radiostereometric analysis (RSA), which is a well-established method for the analysis of micro movements and has been used to monitor percutaneous epiphysiodesis with the bilateral approach. There are no reports in the literature comparing single-with double-portal approaches for percutaneous epiphysiodesis evaluated by RSA. Methods Twenty children were treated by percutaneous epiphysiodesis for leg length discrepancies ranging from 15 to 70 mm, comprising 14 boys and 6 girls with a mean age of 13 (11-15) years. The timing of epiphysiodesis was determined by using Moseley's straight-line graph and Paley's multiplier method. For the tibial epiphysiodesis, ten patients were operated with a single surgical approach from the lateral side (Group I) and ten patients were operated with a surgical approach from both the medial and the lateral sides (Group II). The percutaneous epiphysiodesis was monitored by RSA, a method which allows analysis of the three-dimensional dynamics of the epiphysis relative to the metaphysics. RSA examinations were performed postoperatively and after 6 weeks, 12 weeks, and 6 months.Results From 0 to 6 weeks after epiphysiodesis, the mean longitudinal growth across the operated physis in the tibia in Group I was 0.26 (0.01-0.6) mm. In Group II, the mean growth for the first 6 weeks after surgery was 0.17 (0.01-0.5) mm. During the time period from 6 weeks to 12 weeks after surgery, there was a mean growth of 0.06 (0.00-0.18) mm in Group I and 0.03 (0.00-0.2) mm in Group II. The mean growth from 0 to 6 weeks after epiphysiodesis for all patients was 0.22 mm, which corresponds to 30 % of the normal growth rate. From 6 to 12 weeks, the mean growth for all patients was 0.046 mm, i.e., 6 % of the normal growth rate. From 12 weeks to 24 weeks, no significant growth across the operated physis was observed in neither Group I nor Group II. The mean surgical time was 26 (21-30) min in Conclusions In our study, a single-portal technique from the lateral side for percutaneous epiphysiodesis of the proximal tibia was as effective as the double-portal technique. Actual growth arrest appeared within 12 weeks after surgery. A single-portal technique for epiphysiodesis of the tibia is a safe technique, with less surgical time and less time for image intensification compared to the doubleportal technique.

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Naevi and other Developmental Defects

Moss

Shahidullah

2010

Rook's Textbook of Dermatology

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Percutaneous Epiphyseodesis

Cited by 63 publications

References 0 publications

Percutaneous Radiofrequency Epiphysiodesis in a Rabbit Model: A Pilot Study

Percutaneous Radiofrequency Epiphysiodesis in a Rabbit Model: A Pilot Study

Percutaneous epiphysiodesis in the proximal tibia by a single-portal approach: Evaluation by radiostereometric analysis

Naevi and other Developmental Defects

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