Bilaterality in slipped upper femoral epiphysis

Abstract

The frequency of slipping and osteoarthritis of the contralateral hip was recorded in 260 patients with slipped upper femoral epiphysis between 1910 and 1960. Twenty-three of these patients (9%) had primary bilateral slipping, 32 (12%) had a contralateral slip diagnosed later during adolescence and a further 104 (40%) had signs of contralateral slipping at follow-up 16 to 66 years later, giving a total of 159 cases (61%) with bilateral slips. Of the 104 slippings diagnosed at follow-up, 25% showed osteoarthritis. It is concluded that, with a slipped epiphysis, prophylactic contralateral pinning should be performed to avoid slipping and to reduce the risk of osteoarthritis.

Increased Acetabular Depth May Influence Physeal Stability in Slipped Capital Femoral Epiphysis

“…Patients who initially present with a unilateral SCFE have a risk of developing a contralateral slip that ranges anywhere from 20% to 60% [10,17,24]. Twenty-two percent of our subjects required treatment for a subsequent contralateral SCFE, a rate that is consistent with what has been previously reported.…”

The Fate of Hips That Are Not Prophylactically Pinned After Unilateral Slipped Capital Femoral Epiphysis

“…Excluding patients presenting with bilateral disease, reported rates of documented, symptomatic childhood progression to bilateral disease in children range from 9% to 36% [3,6,10,17,22,33]. Considering asymptomatic disease, other series report a much higher rate of bilateral disease at up to 36% to 79% of patients with unilateral slips developing bilateral disease evident by deformity on radiograph at skeletal maturity [4,11,13]. Prophylactic pinning is offered at some centers to children with unilateral disease to prevent a contralateral slip.…”

Hip Physiolysis: Bilaterality in 62 Cases Followed for 20 years

“…Klein et al (1953) found bilateral slips in 25/61 cases, 17 of which appeared later in adolescence, and Hagglund et al (1988) found bilaterality in 61 percent and arthrosis in 23 percent among the hips diagnosed late in adolescence or at follow-up. Wilson et al (1965) stressed that the contralateral slipping in 8 of 17 patients were painless.…”

“…The reported incidence of bilateral slipped capital femoral epiphysis differs from 5 to 80 percent (Hagglund et al 1988) according to the time of recording: viz., at primary admission, at routine examinations during adolescence, or at follow-up after completion of growth.…”