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Endoscopic-assisted epiphysiodesis: technique and 20-year experience
Justin B Ledesma1, Tianyi Wang, Elizabeth Desmond
1aDepartment of Orthopaedic Surgery, Stanford Hospital and Clinics, Stanford bDepartment of Orthopaedic Surgery, Santa Clara Valley Medical Center, San Jose, California, USA.
Endoscopic-assisted epiphysiodesis is a safe and effective surgical technique for achieving predictable physeal fusion in pediatric patients. This minimally invasive approach reduces radiation exposure and eliminates the need for hardware placement, offering significant advantages over traditional methods.
Area of Science:
- Orthopedic Surgery
- Pediatric Orthopedics
- Minimally Invasive Surgery
Background:
- Epiphysiodesis is a surgical procedure used to correct limb length discrepancies in children.
- Traditional epiphysiodesis techniques often involve open surgery and hardware implantation.
- Minimally invasive techniques aim to reduce surgical morbidity and improve outcomes.
Purpose of the Study:
- To describe the endoscopic-assisted epiphysiodesis technique.
- To review a 20-year experience with this procedure.
- To evaluate its safety, efficacy, and predictability.
Main Methods:
- Retrospective review of 44 patients undergoing proximal tibia and/or distal femur endoscopic-assisted epiphysiodesis.
- Inclusion criteria: preoperative/postoperative scanograms and minimum 6-month follow-up.
- Data analysis focused on physeal fusion and need for revision surgery.
Main Results:
- All 44 patients achieved radiographic physeal fusion within 6-12 months.
- Mean follow-up was 36.8 months.
- No revision surgeries were required.
Conclusions:
- Endoscopic-assisted epiphysiodesis is a safe and effective method for achieving predictable physeal fusion.
- Advantages include reduced radiation exposure and no hardware requirement.
- This technique offers a viable alternative to traditional epiphysiodesis procedures.
