Slipped capital femoral epiphysis: an ultrastructural study before and after osteosynthesis

Falciglia, Francesco; Aulisa, Angelo Gabriele; Giordano, Marco; Boldrini, Renata; Guzzanti, Vincenzo

doi:10.3109/17453674.2010.483987

Cited by 23 publications

(22 citation statements)

References 24 publications

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“…The amount of proteoglycans in the ECM was moderately decreased in the matrix of the physis in SCFE compared to normal [3,7,9]. Also, abnormal proteoglycans were found [5].…”

Section: Histological Changes In Scfementioning

confidence: 92%

“…Interestingly, Adamczyk et al showed that apoptosis was increased throughout the physis in SCFE, in contrast with controls, where apoptosis was found only in the hypertrophic zone [8]. The chondrocytes showed intracellular abnormalities [5,7,9]. An increase in the nuclear and cytoplasmic density was seen in the proliferative and hypertrophic chondrocytes with SCFE and an increase in cytoplasmic glycogen [7,9].…”

Section: Histological Changes In Scfementioning

confidence: 99%

“…The ECM of the physis had abnormal longitudinal septa with deficiency in collagen [3,5,7,9]. The amount of proteoglycans in the ECM was moderately decreased in the matrix of the physis in SCFE compared to normal [3,7,9].…”

Section: Histological Changes In Scfementioning

confidence: 99%

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Slipped capital femoral epiphysis and its association with endocrine, metabolic and chronic diseases: A systematic review of the literature

Witbreuk

Kemenade

Sluijs

et al. 2013

Journal of Children's Orthopaedics

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Purpose Puberty, obesity, endocrine and chronic systemic diseases are known to be associated with slipped capital femoral epiphysis (SCFE). The mechanical insufficiency of the physis in SCFE is thought to be the result of an abnormal weakening of the physis. However, the mechanism at the cellular level has not been unravelled up to now. Methods To understand the pathophysiology of endocrine and metabolic factors acting on the physis, we performed a systematic review focussing on published studies reporting on hormonal, morphological and cellular abnormalities of the physis in children with SCFE. In addition, we looked for studies of the effects of endocrinopathies on the human physis which can lead to cause SCFE and focussed in detail on hormonal signalling, hormone receptor expression and extracellular matrix (ECM) composition of the physis. We searched in the PubMed, EMBASE.com and The Cochrane Library (via Wiley) databases from inception to 11thSeptember 2012. The search generated a total of 689 references: 382 in PubMed, 232 in EMBASE.com and 75 in The Cochrane Library. After removing duplicate papers, 525 papers remained. Of these, 119 were selected based on titles and abstracts. After excluding 63 papers not related to the human physis, 56 papers were included in this review. Results Activation of the gonadal axis and the subsequent augmentation of the activity of the growth hormone-insulin-like growth factor 1 (GH-IGF-1) axis are important for the pubertal growth spurt, as well as for cessation of the physis at the end of puberty. The effects of leptin, thyroid hormone and corticosteroids on linear growth and on the physis are also discussed. Children with chronic diseases suffer from inflammation, acidosis and malnutrition. These consequences of chronic diseases affect the GH-IGF-1 axis, thereby, increasing the risk of the development of SCFE. The risk of SCFE and avascular necrosis in children with chronic renal insufficiency, growth hormone treatment and renal osteodystrophy remains equivocal. Conclusions SCFE is most likely the result of a multifactorial event during adolescence when height and weight increase dramatically and the delicate balance between the various hormonal equilibria can be disturbed. Up to now, there are no screening or diagnostic tests available to predict patients at risk.

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“…The amount of proteoglycans in the ECM was moderately decreased in the matrix of the physis in SCFE compared to normal [3,7,9]. Also, abnormal proteoglycans were found [5].…”

Section: Histological Changes In Scfementioning

confidence: 92%

Section: Histological Changes In Scfementioning

confidence: 99%

See 1 more Smart Citation

Slipped capital femoral epiphysis and its association with endocrine, metabolic and chronic diseases: A systematic review of the literature

Witbreuk

Kemenade

Sluijs

et al. 2013

Journal of Children's Orthopaedics

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“…Ultrastructural analysis shows slippage of the physis occurs secondary to weakness of the supporting fibrous network caused by collagen disturbance [2,19,57]. Mechanical [4,20,45,68], endocrine [52,85,86], and metabolic disorders of puberty [60] have been postulated to cause the pathological disturbance in the growth plate that ultimately fail mechanically and slip.…”

Section: Search Strategies and Criteriamentioning

confidence: 99%

Slipped Capital Femoral Epiphysis: Prevalence, Pathogenesis, and Natural History

Novais

Millis

2012

Clinical Orthopaedics &Amp; Related Research

135

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Background Obesity is a risk factor for developing slipped capital femoral epiphysis (SCFE). The long-term outcome after SCFE treatment depends on the severity of residual hip deformity and the occurrence of complications, mainly avascular necrosis (AVN). Femoroacetabular impingement (FAI) is associated with SCFE-related deformity and dysfunction in both short and long term. Questions/Purposes We examined obesity prevention, early diagnosis, reducing AVN and hip deformity as strategies to reduce SCFE prevalence, and the long-term outcomes after treatment. Methods A search of the literature using the PubMed database for the key concepts SCFE and treatment, natural history, obesity, and prevalence identified 218, 15, 26, and 49 abstracts, respectively. Where Are We Now? A correlation between rising childhood obesity and increasing incidence of SCFE has been recently reported. Residual abnormal morphology of the proximal femur is currently believed to be the mechanical cause of FAI and early articular cartilage damage in SCFE. Where Do We Need to Go? Reducing the increasing prevalence rate of SCFE is important. Treatment of SCFE should aim to reduce AVN rates and residual deformities that lead to FAI to improve the long-term functional and clinical outcomes. How Do We Get There? Implementing public health policies to reduce childhood obesity should allow for SCFE prevalence to drop. Clinical trials will evaluate whether restoring the femoral head-neck offset to avoid FAI along with SCFE fixation allows for cartilage damage prevention and lower rates of osteoarthritis. The recently described surgical hip dislocation approach is a promising technique that allows anatomic reduction with potential lower AVN rates in the treatment of SCFE.

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“…It could be hypothesized that these aspects of the fibrocartilage are the result of tissue weakness due to a physiopathologic modification during pubertal growth as reported in slipped capital femoral epiphyses (SCFE) (18,19).…”

Section: Discussionmentioning

confidence: 99%

Osgood Schlatter Lesion: Histologic Features of Slipped Anterior Tibial Tubercle

Falciglia

Giordano

Aulisa

et al. 2011

Int J Immunopathol Pharmacol

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No study reports the histological features of the various zone of the anterior tubercle of the tibia in the different stages of the Osgood-Schlatter (O-S) lesion. For this reason we carried on an histological study. Specimens were taken from 13 patients with O-S lesion prior to surgery. In 4 cases in the apophyseal stage lesions were present in an altered fibrocartilage anterior to the ossification centre. In 9 cases in the epiphyseal stage varying degrees of reparative tissues were observed in the bed of the fragment of the secondary ossification centre. In 3 of them a zone of lesion was observed within the fibrocartilage anterior to the ossification centre. These results suggest that the slippage of the patellar tendon insertion may be progressive and caused by pathological fibrocartilage.

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Slipped capital femoral epiphysis: an ultrastructural study before and after osteosynthesis

Cited by 23 publications

References 24 publications

Slipped capital femoral epiphysis and its association with endocrine, metabolic and chronic diseases: A systematic review of the literature

Slipped capital femoral epiphysis and its association with endocrine, metabolic and chronic diseases: A systematic review of the literature

Slipped Capital Femoral Epiphysis: Prevalence, Pathogenesis, and Natural History

Osgood Schlatter Lesion: Histologic Features of Slipped Anterior Tibial Tubercle

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