Severe slipped capital femoral epiphysis: A French multicenter study of 186 cases performed by the SoFOP

Amara, S. Abu; Cunin, Vincent; Ilharreborde, Brice

doi:10.1016/j.otsr.2015.04.005

Cited by 25 publications

(16 citation statements)

References 30 publications

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“…Loder showed that AVN developed in 47% of unstable slips but none of the stable hips. This finding has been replicated by others [ 3 – 6 , 71 ].…”

Section: Discussionsupporting

confidence: 80%

“…Six studies (324 hips) provided useful data on the rate of FAI [ 43 , 46 , 57 , 58 , 70 , 71 ]. These studies investigated pinning in situ, physeal osteotomy and Ganz surgical dislocation.…”

Section: Discussionmentioning

confidence: 99%

“…The difference was statistically significant [Fisher exact test ( df = 2): P < 0.001]. One study [ 71 ] reported the presence of radiological signs of FAI in 30 of 37 hips that were treated with pinning in situ. The study was not explicit about their impingement symptoms.…”

Section: Discussionmentioning

confidence: 99%

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Treatment of stable slipped capital femoral epiphysis: systematic review and exploratory patient level analysis

et al. 2017

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Background Several aspects of slipped capital femoral epiphysis (SCFE) treatment remain controversial. Loder's work has been instrumental in changing our understanding and approach to the management of the condition when he introduced the concept of ''slip instability'' and showed that avascular necrosis (AVN) developed in 47% of unstable slips but none of the stable slips. As the two types of SCFE behave differently in terms of presentation, progress and complications, we approached them as two different conditions to highlight these differences. This paper focuses on treatments of stable SCFE. Materials and methods An extensive literature search was carried out from multiple databases. One thousand six hundred and twenty-three citations were screened. Three hundred and sixteen full publications were obtained for further scrutiny. Fifty-eight studies (2262 hips) were included in the review. These studies evaluated 6 interventions. AVN was chosen as a surrogate for bad outcome. Secondary outcomes were chondrolysis (CL), femoro-acetabular impingement (FAI), osteoarthritis (OA) and patients' reported outcomes. The latter were pooled when they met our predefined criteria. Results The type of surgical intervention was an important risk factor. Pinning in situ (PIS) was associated with the lowest AVN rate (1.4%). Moreover, the CL, FAI and OA rates were relatively low in patients who underwent PIS.

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“…Loder showed that AVN developed in 47% of unstable slips but none of the stable hips. This finding has been replicated by others [ 3 – 6 , 71 ].…”

Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 99%

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Treatment of stable slipped capital femoral epiphysis: systematic review and exploratory patient level analysis

et al. 2017

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“…This finding is in contrast to previous reports, which showed that a severe slip has a higher percentage of AVN. 4 , 5 …”

Section: Discussionmentioning

confidence: 99%

“…A multi-centre French study concluded that prevention of AVN, osteoarthritis (OA) and FAI should be considered as the goal of treatment by using the anterior Dunn procedure for severe slips. 5 In the SCFE-affected hip, the presence of FAI causes mechanical abnormalities that can lead to osteoarthritis due to repetitive injury to the articular cartilage. Considering this situation, preventing impingement is preferable, rather than treating it later.…”

Section: Introductionmentioning

confidence: 99%

Outcome of pinning in patients with slipped capital femoral epiphysis: risk factors associated with avascular necrosis, chondrolysis, and femoral impingement

et al. 2017

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ObjectiveThis study aimed to assess the principal risk factors that could lead to the most common long-term complications of slipped capital femoral epiphysis, such as avascular necrosis, chondrolysis, and hip impingement.MethodsWe conducted a single-centre, retrospective study and evaluated patients (70 patients, 81 hips) who were treated for slipped capital femoral epiphysis from 2010 to 2015 and who underwent pinning. We measured the severity of displacement radiologically using the Southwick angle. Postoperative radiographs were evaluated for the most frequent long-term complications of avascular necrosis (AVN), chondrolysis, and femoral acetabular impingement (FAI).ResultsWe found seven cases of AVN, 14 cases of chondrolysis, and 31 hips had an α angle of 60°. Sex, ambulation, and symptoms did not affect development of these complications. Patients with a normal weight were almost two times more likely to develop FAI. Patients with moderate and severe slips had a similar percentage of AVN. In severe slips, 85.7% of patients had an α angle higher than 60°.ConclusionsThis study shows that severe slips have a higher risk of developing AVN and hip impingement. Every patient who suffers from SCFE (even the mildest forms) should be regularly checked for FAI.

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Slipped Capital Femoral Epiphysis

Novais

Loder

2021

Evidence‐Based Orthopedics

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Severe slipped capital femoral epiphysis: A French multicenter study of 186 cases performed by the SoFOP

Cited by 25 publications

References 30 publications

Treatment of stable slipped capital femoral epiphysis: systematic review and exploratory patient level analysis

Treatment of stable slipped capital femoral epiphysis: systematic review and exploratory patient level analysis

Outcome of pinning in patients with slipped capital femoral epiphysis: risk factors associated with avascular necrosis, chondrolysis, and femoral impingement

Slipped Capital Femoral Epiphysis

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