Epiphysiolysis of the Head of the Femur:<i>A Follow-up Examination with Special Reference to End Results and the Social Prognosis</i>

Oram, V

doi:10.3109/17453675308991203

Cited by 43 publications

(12 citation statements)

References 2 publications

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“…No other article to our knowledge has reported such coxometric results with such a long term follow up. If it is certain that the abstention or the continuous traction are no longer viable solutions, 39,40 the modified Dunn osteotomy seems to be an alternative to the ISF. 8,41,42 This surgery is performed by an anterior approach, respecting the posterior circumflex artery and diminishing the risk of necrosis of the femoral head in comparison to a posterior approach.…”

Section: Discussionmentioning

confidence: 99%

Long-term evolution of slipped capital femoral epiphysis treated by in situ fixation: a 26 years follow-up of 11 hips

2014

Orthop Rev

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Slipped capital femoral epiphysis (SFCE) may lead to femoro acetabular impingement and long-term function impairment, depending on initial displacement and treatment. There are several therapeutic options which include in situ fixation (ISF). The objective of this study was to evaluate long-term functional and radiographic outcomes of patients with SFCE treated with ISF. We conducted a single-center, retrospective study evaluating the clinical and radiographic outcomes of SCFE in situ fixation with a mean follow-up of 26 years (10-47). Analysis of preoperative and last follow up radiographs was performed. The functional status of the hip was evaluated according to the Oxford hip score-12 and the radiographic osteoarthritis stage was rated according to Tönnis classification. Signs of femoro acetabular impingement were sought. Ten patients (11 hips) were included. The average initial slip was 33.5° (10-62). At final follow up, the average Oxford hip score was 19.3 (12-37), it was good for groups who had a small initial slip (16.7) or moderate (17) and fair for the severe group (27). Average Tönnis grade was 1.3 (0-3). The average alpha angle was 65.3° (50-80°). Femoro acetabular impingement was likely in 100% of patients with severe slip, in 50% of patients with moderate slip and in 33% of patients with a slight slip. In situ fixation generated poor functional results, substantial hip osteoarthritis and potential femoro acetabular impingement in moderate to severe SCFE’s. However, in cases with minor displacement, functional and radiographic results are satisfactory. The cut off seems to be around 30° slip angle, above which other treatment options should be considered.

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Section: Discussionmentioning

confidence: 99%

Long-term evolution of slipped capital femoral epiphysis treated by in situ fixation: a 26 years follow-up of 11 hips

2014

Orthop Rev

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“…In slipped capital femoral epiphyses (SCFE), severity of slippage correlates with poor long-term clinical outcome scores and radiographic evidence of osteoarthritis [11,17,51]. In situ fixation of higher-grade SCFE has a low surgical risk [11,29] and has been advocated by authors who believe the deformed hip has the potential to remodel with some restoration of the disturbed anatomic axes [7,8,33,50].…”

Section: Introductionmentioning

confidence: 99%

Capital Realignment for Moderate and Severe SCFE Using a Modified Dunn Procedure

Ziebarth

Zilkens²,

Spencer³

et al. 2009

Clinical Orthopaedics &Amp; Related Research

265

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Moderate to severe slipped capital femoral epiphysis leads to premature osteoarthritis resulting from femoroacetabular impingement. We believe surgical correction at the site of deformity through capital reorientation is the best procedure to fully correct the deformity but has traditionally been associated with high rates of osteonecrosis. We describe a modified capital reorientation procedure performed through a surgical dislocation approach. We followed 40 patients for a minimum of 1 year and 3 years from two institutions. No patient developed osteonecrosis or chondrolysis. Slip angle was corrected to 4°to 8°and the mean alpha angle after correction was 40.6°. Articular cartilage damage, full-thickness loss, and delamination were observed at the time of surgery, especially in the stable slips. This technique appears to have an acceptable complication rate and appears reproducible for full correction of moderate to severe slipped capital femoral epiphyses with open physes.

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“…In SCFE, a direct correlation has been presumed between slip severity and patient long-term outcome with less favourable results for patients with more severe deformity [1][2][3]. OA due to SCFE is reported to develop in up to 41% of the cases [4].…”

Section: Introductionmentioning

confidence: 99%

Significance of clinical and radiographic findings in young adults after slipped capital femoral epiphysis

Zilkens

Bittersohl

Jäger

et al. 2010

International Orthopaedics (SICOT)

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The purpose of this study was to assess the clinical and radiographic presentation of young adults in the mid-term follow-up after pinning in situ for mild to moderate slipped capital femoral epiphysis (SCFE). We postulated that there was a correlation between the degree of head-neck-offset decrease and clinical and radiographic signs of hip joint degeneration. Thirty-eight young adults (average age 23.4±3.6 years old) with various grades of femoral head-neck-offset pathologies were assessed clinically via Harris hip score (HHS), Tegner-Lysholm score (TLS) and Short Form 36 (SF-36), and radiographic signs of OA were measured on plain X-ray films after a follow-up of 11.1±3.8 years. We conclude that clinical and radiographic signs of joint degeneration appear early in the follow-up after SCFE, but there is no linear correlation between offset-pathology and joint degeneration.

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Epiphysiolysis of the Head of the Femur:A Follow-up Examination with Special Reference to End Results and the Social Prognosis

Cited by 43 publications

References 2 publications

Long-term evolution of slipped capital femoral epiphysis treated by in situ fixation: a 26 years follow-up of 11 hips

Long-term evolution of slipped capital femoral epiphysis treated by in situ fixation: a 26 years follow-up of 11 hips

Capital Realignment for Moderate and Severe SCFE Using a Modified Dunn Procedure

Significance of clinical and radiographic findings in young adults after slipped capital femoral epiphysis

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