Developing microwave epiphysiodesis to correct limb length discrepancies

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PROJECT ABSTRACT This project addresses a need for less morbid alternatives to surgical drilling of growth plates in the treatment of limb length discrepancies. Surgical approaches currently require 6 weeks of recovery before weight bearing, which takes a physical and psychological toll on pediatric patients. Surgery has also been associated with complications such as incomplete growth arrest, angular deformity, bleeding, and infection. We hypothesize that microwave ablation – a technology already used for treating malignant and benign tumors throughout the body, including in bones – can be used to disrupt the growth plate with fewer complications and faster return to baseline activity. Preliminary data demonstrates the feasibility delivering microwave energy to create heating in the growth plate when using clinical microwave tumor ablation systems in porcine tibias. This project will focus on developing more optimal devices and techniques for growth plate ablation. Directional antennas will be developed that target microwave energy to the growth plate while minimizing collateral damage. Dynamic positioning and multi-applicator techniques will be used to further refine energy delivery to ensure complete and uniform growth arrest. Finally, the safety and efficacy of the optimized techniques will be compared against the gold-standard of surgical drilling in distal femur, proximal tibia, and fibula. If successful, these developments and studies will form the basis for a novel and exciting treatment for limb length discrepancy in children.