Epidemiology of Slipped Capital Femoral Epiphysis in Ontario, Canada

Ravinsky, Robert; Rofaiel, J R; Escott, Benjamin G.; Lim, Zachary; Ravi, Bheeshma; Howard, Andrew

doi:10.1097/bpo.0000000000001254

Cited by 13 publications

(6 citation statements)

References 14 publications

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“…Associa-tions between SCFE and obesity and hypothyroidism have been described but many studies used a retrospective design and small cohorts (Bhatia et al 2006, Ucpunar et al 2018. In the past years reports from national databases have increased (Murray and Wilson 2008, Herngren et al 2017, Perry et al 2017, Ravinsky et al 2019, making it possible to analyze epidemiological characteristics of different disease conditions. However, studies emerging from these databases lack a control group or have only appeared in the past decade, making it difficult to make observations before and after exposure or to analyze changes of incidences over time.…”

Section: Discussionmentioning

confidence: 99%

Fate of patients with slipped capital femoral epiphysis (SCFE) in later life: risk of obesity, hypothyroidism, and death in 2,564 patients with SCFE compared with 25,638 controls

Hailer

2020

Acta Orthopaedica

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Background and purpose — Associations between obesity and slipped capital femoral epiphysis (SCFE) during adolescence are described; however, few studies report on the lifetime risk of obesity in patients with SCFE. In addition, with the obesity epidemic in children and adolescents, an increasing incidence of SCFE might be expected. An association of SCFE with hypothyroidism seems ambiguous, and the association between SCFE and depression and all-cause mortality has not yet been evaluated. This study investigates the associations of SCFE with obesity, hypothyroidism, depression, and mortality, and putative changes in the yearly incidence of SCFE. Patients and methods — 2,564 patients diagnosed with SCFE at age 5–16 diagnosed between 1964 and 2011 were identified in the Swedish Patient Register. These were matched for age, sex, and residency with unexposed control individuals. Cox regression models were fitted to estimate the risk of obesity, hypothyroidism, depression, and death, in exposed compared with unexposed individuals. Results — The risk of obesity (HR 9, 95% CI 7–11) and hypothyroidism (HR 3, CI 2–4) was higher in SCFE patients compared with controls. There was no increase in the risk of developing depression (HR 1, CI 1–1.3) in SCFE patients. In contrast, all-cause mortality was higher in SCFE patients than in controls (HR 2, CI 1–2). The incidence of SCFE did not increase over the past decades. Interpretation — Patients with SCFE have a higher lifetime risk of obesity and hypothyroidism and a higher risk of all-cause mortality compared with individuals without SCFE. These findings highlight the lifetime comorbidity burden of patients who develop SCFE in childhood, and increased surveillance of patients with a history of SCFE may be warranted. The incidence of SCFE did not increase over the last decades despite increasing obesity rates.

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Section: Discussionmentioning

confidence: 99%

Fate of patients with slipped capital femoral epiphysis (SCFE) in later life: risk of obesity, hypothyroidism, and death in 2,564 patients with SCFE compared with 25,638 controls

Hailer

2020

Acta Orthopaedica

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“…Traditionally, SCFE has been treated by in situ fixation of the femoral head with a single cannulated screw to inhibit further slippage 5 , 6 . In situ fixation with screws can consequentially cause a physeal arrest, which leads to a relative shortening of the femoral neck 7 – 9 and subsequent LLD 4 , 10 . As SCFE usually occurs before skeletal maturity, we can assume that the degree of LLD may be greater in younger patients.…”

Section: Discussionmentioning

confidence: 99%

Leg length discrepancy after in situ fixation with screw for slipped capital femoral epiphysis

Kim

Park

Kim

et al. 2022

Sci Rep

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Although leg length discrepancy (LLD) commonly occurs following in situ fixation with screws for slipped capital femoral epiphysis (SCFE), the literature regarding this issue is scarce. The purpose of this study was to evaluate the degree of LLD in patients who had been treated with in situ fixation with screws and to identify the risk factors for the development of LLD. We retrospectively reviewed 44 patients (mild slip 24, moderate slip, 20) who were treated with in situ fixation with screws for SCFE. The mean age at surgery was 12.2 years and the mean follow-up period was 6.9 years. We investigated the relationship between the final LLD, articulotrochanteric distance difference (ATDD) at skeletal maturity, and various clinical and radiographic parameters using linear regression analysis. The mean values of LLD and ATDD were 13.1 and 11.1 mm, respectively. The LLD and ATDD was significantly higher in patients with moderate slips than in those with mild slips. The degree of slip angle was associated with the degree of LLD only. While there was no significant factor affecting the LLD in moderate slips, younger age and a larger degree of slip angle were associated with the degree of LLD. The degree of slip was the only factor that affected LLD in patients with mild or moderate SCFE who underwent threaded screw fixation. Age at surgery was not associated with LLD, and there were no factors related to the degree of LLD in mild slip. Monitoring for LLD may only be necessary for patients with moderate slip who are treated with in situ screw fixation.

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“…The treatment of SCFE is surgical, mainly aimed at avoiding progression of deformity. 16 The controlled surgical dislocation of the hip is a procedure to rebuild and stabilize slipping of the proximal femoral epiphysis in order to restore full functionality. The surgical technique has a long learning curve, and is considered a major surgical procedure, anticipating major trans-operative bleeding.…”

Section: Discussionmentioning

confidence: 99%

Intraoperative blood salvage in proximal femur epiphysiolysis surgical treatment with hip controlled dislocation technique: a case series study

Colares

Carlos²,

Ramos³

et al. 2021

Brazilian Journal of Anesthesiology (English Edition)

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Epidemiology of Slipped Capital Femoral Epiphysis in Ontario, Canada

Cited by 13 publications

References 14 publications

Fate of patients with slipped capital femoral epiphysis (SCFE) in later life: risk of obesity, hypothyroidism, and death in 2,564 patients with SCFE compared with 25,638 controls

Fate of patients with slipped capital femoral epiphysis (SCFE) in later life: risk of obesity, hypothyroidism, and death in 2,564 patients with SCFE compared with 25,638 controls

Leg length discrepancy after in situ fixation with screw for slipped capital femoral epiphysis

Intraoperative blood salvage in proximal femur epiphysiolysis surgical treatment with hip controlled dislocation technique: a case series study

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