Morphologic Features of the Contralateral Femur in Patients With Unilateral Slipped Capital Femoral Epiphysis Resembles Mild Slip Deformity: A Matched Cohort Study

Hesper, Tobias; Bixby, Sarah D.; Maranho, Daniel A; Miller, Patricia E.; Kim, Young-Jo; Novais, Eduardo N.

doi:10.1007/s11999.0000000000000127

Cited by 9 publications

(9 citation statements)

References 39 publications

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“…Additionally, up to one-third of the contralateral hips with a postslip deformity develop signs of radiographic osteoarthritis at followup ranging from 16 to 66 years [14,19]. There also is concerning evidence that even mild SCFE deformity can lead to femoroacetabular impingement (FAI) [10,35] and articular cartilage damage that may increase the risk of later osteoarthritis development [17,25,38].…”

Section: Introductionmentioning

confidence: 99%

What Is the Prevalence of Cam Deformity After Prophylactic Pinning of the Contralateral Asymptomatic Hip in Unilateral Slipped Capital Femoral Epiphysis? A 10-year Minimum Followup Study

Lerch

Novais

Schmaranzer

et al. 2018

Clin Orthop Relat Res

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Background Prophylactic pinning of the asymptomatic and normal-appearing contralateral hip in patients with unilateral slipped capital femoral epiphysis (SCFE) remains controversial. Understanding the minimal 10-year clinical, functional, and radiographic outcomes of the contralateral asymptomatic hip in unilateral SCFE may be helpful in the decision regarding whether the benefits associated with potentially preventing a SCFE are outweighed by the risk of additional surgery. Questions/purposes Among patients with SCFE treated with prophylactic pinning of the asymptomatic and contralateral hip, we sought (1) to determine the complications and reoperations; (2) to evaluate the development of cam deformities and the frequency and severity of osteoarthritis progression; and (3) to characterize hip pain and function as measured by the Harris hip score (HHS) and the Hip Disability and Osteoarthritis Outcome Score (HOOS) at minimal 10-year followup. Methods Between 1998 and 2005 all patients with SCFE seen at our institution were treated with the modified Dunn procedure and all were offered prophylactic pinning of the contralateral asymptomatic hip. Of the 41 patients who The institution of one or more of the authors (MT) has received, during the study period, funding from the Swiss National Science Foundation. Each author certifies that neither he, nor any member of his immediate family, has funding or commercial associations (consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. Clinical Orthopaedics and Related Research® neither advocates nor endorses the use of any treatment, drug, or device. Readers are encouraged to always seek additional information, including FDA approval status, of any drug or device before clinical use. Each author certifies that his institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

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Section: Introductionmentioning

confidence: 99%

What Is the Prevalence of Cam Deformity After Prophylactic Pinning of the Contralateral Asymptomatic Hip in Unilateral Slipped Capital Femoral Epiphysis? A 10-year Minimum Followup Study

Lerch

Novais

Schmaranzer

et al. 2018

Clin Orthop Relat Res

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“…We believe that the original SCFE deformity could have influenced the acetabular development despite subsequent FAI treatment. Finally, the morphology of the contralateral uninvolved side in unilateral SCFE may resemble a slip-like deformity, 54 and we do not have a matched-control group of healthy individuals to compare the acetabular morphology across time.…”

Section: Discussionmentioning

confidence: 99%

Acetabular morphology in slipped capital femoral epiphysis: Comparison at treatment onset and skeletal maturity

Maranho

Dávila-Parrilla

Miller

et al. 2018

Journal of Children's Orthopaedics

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Abstract:PurposeTo investigate changes in acetabular morphology during the follow-up of slipped capital femoral epiphysis (SCFE) and search for factors associated with acetabular dysplasia at skeletal maturity.MethodsWe evaluated 108 patients with unilateral SCFE (mean age at slip, 12.3 years sd 1.7) to skeletal maturity, with a minimum follow-up of two years (median 4.5 years; interquartile range 3.2 to 6.2). Acetabular parameters obtained from initial and most recent radiographs included the lateral centre-edge angle (LCEA), Tönnis angle (TA) and acetabular depth-width ratio (ADR). Acetabular dysplasia was considered for LCEA < 20° or TA > 10°. Femoral parameters consisted of the most recent head diameter, neck-shaft angle, neck length, articulotrochanteric distance and alpha angle.ResultsAt SCFE onset, the affected hip showed a slightly lower LCEA (26.4° sd 6.1° versus 27.3° sd 5.7°; p = 0.01) and ADR (330 sd 30 versus 340 sd 30; p < 0.001) compared with the uninvolved hip. At final follow-up, the affected hip showed lower LCEA (24.5° sd 7.6° versus 28.8°sd 6.6°; p < 0.001) and ADR (330 sd 40 versus 350 sd 40; p < 0.001), and TA was larger (5.5° sd 5.4° versus 2.3° sd 4.2°; p < 0.001) compared with the uninvolved hip. Acetabular dysplasia was observed in 27 (25%) of 108 hips with SCFE. Femoral head overgrowth, age at slip and SCFE severity were independent factors associated with acetabular dysplasia (p < 0.05).ConclusionAcetabular coverage and depth are not increased in SCFE, and the acetabular coverage tends to decrease up to skeletal maturity. A potential disturbance in the acetabular growth and remodelling exists mainly for young children with severe SCFE, and a potential for acetabular insufficiency may be observed at the diagnosis and follow-up of SCFE.Level of EvidencePrognostic Level IV

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“…Initial treatment goals consist of stabilizing the epiphysis with in situ pinning. However, the SCFE deformity can lead to early, persistent femoroacetabular impingement and chondral injury in these patients [54][55][56]. While arthroscopic treatment is successful in lower grade slips, surgical hip dislocation is indicated in more severe deformities.…”

Section: Slipped Capital Femoral Epiphysis (Scfe)mentioning

confidence: 99%

“…Parvizi et al described a mini open technique with the patient positioned supine, while this approach does limit the access to the femoral and acetabular visualization [54].…”

Section: Mini Open Direct Anterior Approachmentioning

confidence: 99%

Surgical Treatment for FAI: Arthroscopic and Open Techniques for Osteoplasty

Dukas

Gupta

Peters

et al. 2019

Curr Rev Musculoskelet Med

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Purpose of Review To review the relevant literature and techniques regarding arthroscopic and open treatment of femoroacetabular impingement (FAI). To discuss both the senior authors' preferred method of arthroscopic and open treatment of FAI. Recent Findings Routine treatment of FAI has moved away from open techniques and is more focused arthroscopic methods. Arthroscopic treatment of FAI has more recently focused on differing techniques of hip access and capsular management. Open techniques still have a role in FAI, but indications for open management are focused on cases with more severe pathology.Summary While arthroscopic techniques have shown better outcomes in the short term and higher return to play, it is not without risk and is a procedure with a steep learning curve. In cases of complex joint pathology, such as FAI coupled with dysplasia or Legg-Calve-Perthes, arthroscopy may be not indicated and an open approach preferred. We outline various techniques for both arthroscopic and open treatment of FAI and their outcomes when possible.

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Morphologic Features of the Contralateral Femur in Patients With Unilateral Slipped Capital Femoral Epiphysis Resembles Mild Slip Deformity: A Matched Cohort Study

Cited by 9 publications

References 39 publications

What Is the Prevalence of Cam Deformity After Prophylactic Pinning of the Contralateral Asymptomatic Hip in Unilateral Slipped Capital Femoral Epiphysis? A 10-year Minimum Followup Study

What Is the Prevalence of Cam Deformity After Prophylactic Pinning of the Contralateral Asymptomatic Hip in Unilateral Slipped Capital Femoral Epiphysis? A 10-year Minimum Followup Study

Acetabular morphology in slipped capital femoral epiphysis: Comparison at treatment onset and skeletal maturity

Surgical Treatment for FAI: Arthroscopic and Open Techniques for Osteoplasty

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