Arthroscopic Femoral Neck Osteoplasty in Slipped Capital Femoral Epiphysis

Chen, Austin; Youderian, Ari R.; Watkins, Summer; Gourineni, Prasad

doi:10.1016/j.arthro.2014.05.024

Cited by 34 publications

(31 citation statements)

References 25 publications

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“…Chen at al reported on 34 cases in 2014. 5 The initial slip was mild in 21 hips, moderate in 16 and severe in three. The age range at the time of the procedure was 10 to 19 years.…”

Section: Resultsmentioning

confidence: 97%

Slipped capital femoral epiphysis management and the arthroscope

Accadbled

May

Thévenin-Lemoine

et al. 2017

Journal of Children's Orthopaedics

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BackgroundIn situ pinning of slipped capital femoral epiphysis (SCFE) results in various degrees of deformity of the femoral head-neck junction. Repetitive trauma from cam-type femoroacetabular impingement (FAI) can lead to labral tears and injury to the articular cartilage causing loss of function. Arthroscopic osteoplasty is an alternative to open procedure and to Southwick/Imhäuser-type osteotomies in symptomatic selected cases.Surgical techniqueThe amount of bone to be resected has to be carefully planned pre-operatively. Only gentle traction is applied on a well-padded perineal support. A spherical burr is used to gradually resect the prominence. Intra-operative fluoroscopy is very useful when checking adequate reshaping of the head-neck junction is obtained.ResultsArthroscopy often reveals acetabular cartilage lesions, labrum hyperhemia and fraying which rarely require repair. Arthroscopic osteoplasty provides satisfactory pain relief and, to a lesser extent, restores hip internal rotation.ConclusionArthroscopic osteoplasty is more technically and time-demanding in post SCFE than idiopathic FAI. It requires strong arthroscopic skills and experience in hip arthroscopy. It stands as a reasonable alternative to open procedure or flexion osteotomies in symptomatic FAI post mild to moderate SCFE. It provides pain relief and to a lesser extent restores internal rotation of the hip.

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“…Chen at al reported on 34 cases in 2014. 5 The initial slip was mild in 21 hips, moderate in 16 and severe in three. The age range at the time of the procedure was 10 to 19 years.…”

Section: Resultsmentioning

confidence: 97%

Slipped capital femoral epiphysis management and the arthroscope

Accadbled

May

Thévenin-Lemoine

et al. 2017

Journal of Children's Orthopaedics

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show abstract

“…Moreover, morbid obesity, scarring from previous surgery, and the presence of screws in the anterior neck presented challenges to the arthroscopic technique [83]. As with open OCP, the timing of arthroscopic OCP in relation to in situ fixation is still controversial.…”

Section: The Role Of Hip Arthroscopymentioning

confidence: 99%

Slipped capital femoral epiphysis: a review of management in the hip impingement era

Mahran

Baraka

Hefny

2017

SICOT-J

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Slipped capital femoral epiphysis (SCFE) remains the most common adolescent hip disorder. Most cases present with stable slips, and in situ fixation is the most commonly adopted treatment worldwide. The introduction of the concept of femoroacetabular impingement and subsequent studies have revealed SCFE-related hip impingement to be a significant pre-arthritic condition, and the previously suggested remodeling of the proximal femur after in situ fixation has been called into question. Complex proximal femoral osteotomies and more recently intra-articular procedures via surgical hip dislocation have been employed. The literature is still lacking a strong evidence to undertake such aggressive procedures. Moreover, the application of a particular procedure regarding the nature of the slip, being stable or unstable, the degree of the slip, and the condition of the physis has not been extensively described in the literature. The purpose of this article is to outline the SCFE-related hip impingement, to review the best evidence for the current treatment options for both stable and unstable slips, and to develop an algorithm for decision making.

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“…Options for the treatment of FAI in SCFE include open reduction with the modified Dunn technique [61,62], flexion interochanteric osteotomy (with or without osteoplasty) [63–65], a combined limited anterior surgical approach with arthroscopy [66] and arthroscopic osteoplasty [67,68]. Chen et al [68] in a series of 40 hips treated by in situ fixation (if previously not stabilized) and arthroscopic femoral neck osteoplasty reported successful results in 88% of patients as measured by relief of pain and obtaining neutral or greater internal rotation measured at 90° of hip flexion. Acetabular morphology needs to be assessed as well for potential acetabular over coverage [69–71].…”

Section: Specific Disordersmentioning

confidence: 99%

The use of hip arthroscopy in the management of the pediatric hip

Roy

2015

J Hip Preserv Surg

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Arthroscopy of the pediatric hip began in 1977 with a publication by Gross. Interest was relatively slow to develop in the 1980s and 1990s. Coupled with the success of hip arthroscopy in the adult, interest heightened in applying the procedure to a variety of pediatric hip disorders, given that the alternative was an open surgical hip dislocation. The success of this initial group of pediatric hip arthroscopist’s has further expanded the application of hip arthroscopy as the primary or adjunct procedure for the management of intra-articular problems of the pediatric hip.

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Arthroscopic Femoral Neck Osteoplasty in Slipped Capital Femoral Epiphysis

Cited by 34 publications

References 25 publications

Slipped capital femoral epiphysis management and the arthroscope

Slipped capital femoral epiphysis management and the arthroscope

Slipped capital femoral epiphysis: a review of management in the hip impingement era

The use of hip arthroscopy in the management of the pediatric hip

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