title: Dual 8-plate technique is not as effective as ablation for epiphysiodesis about the knee.
abstract: BACKGROUND
  Lower extremity length inequality can be problematic in children and is often addressed surgically. Several techniques have traditionally been utilized for epiphysiodesis, the goal being physeal ablation. Recently, 8-plates, initially developed for hemiepiphysiodesis, have been extended to epiphysiodesis by placing the plates on both medial and lateral sides of the physis. No prior studies have compared 8-plates with physeal ablation techniques.
  
  
  METHODS
  Between January 2003 and August 2009, 27 patients underwent epiphysiodesis surgery using either physeal ablation or 8-plate technique. Sixteen patients had physeal ablation and 11 had dual 8-plates. A retrospective chart review sought demographic data, outcomes, and complications. Radiographs were reviewed to measure pretreatment and posttreatment limb lengths.
  
  
  RESULTS
  The median improvement in limb length discrepancy was 15.5 mm in the physeal ablation group and 4 mm in the 8-plate group (P<0.001). This difference was maintained following linear regression factoring out the effect of time (10.78 mm for ablation vs. 5.62 mm for 8-plates; P=0.016). There was no statistically significant difference in complication rate between the groups (P=0.112).
  
  
  CONCLUSIONS
  Our study demonstrated physeal ablation to be a significantly superior treatment compared with dual 8-plates for epiphysiodesis. Despite theoretical advantages of 8-plates to perform epiphysiodesis about the knee, this study does not recommend the use of medial and lateral 8-plates to effect epiphysiodesis.
  
  
  METHODS
  Therapeutic III.
authors.affiliation: *University of New Mexico School of Medicine †University of New Mexico Carrie Tingley Hospital ‡Department of Orthopaedics and Rehabilitation, University of New Mexico Carrie Tingley Hospital, Albuquerque, NM.
authors.forename: Daniel
authors.initials: D
authors.lastname: Stewart
authors.forename: Asad
authors.initials: A
authors.lastname: Cheema
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Szalay
mesh_terms: D000293:Adolescent; D002648:Child; D004838:Epiphyses / Q000601:surgery*; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D007870:Leg Length Inequality / Q000601:surgery*; D008297:Male; D009516:New Mexico; D019637:Orthopedic Procedures / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome