Total hip arthroplasty in patients with slipped capital femoral epiphysis: a systematic analysis of 915 cases

Abstract

There is limited evidence on the outcomes of Total Hip Arthroplasty (THA) in Slipped Capital Femoral Epiphysis (SCFE) patients. This systematic review aims to evaluate the current literature in terms of survival rate, functional outcomes, complications and types of implants of THA in SCFE patients. Following the established methodology of PRISMA guidelines, PubMed, Cochrane library, ScienceDirect and Ovid MEDLINE were systematically searched from inception to September 2018. The search criteria used were: (“total hip arthroplasty’’ OR ‘’total hip replacement’’ OR “hip arthroplasty’’ OR ‘’hip replacement’’) AND (‘’slipped capital femoral epiphysis’’ OR ‘’slipped upper femoral epiphysis’’ OR ‘’femoral epiphysis’’). Ten studies were finally included in the analysis and were qualitatively appraised using the Newcastle-Ottawa tool. Variables were reported differently between studies. The sample size varied from 12 to 374 THAs. A total of 877 patients undergone 915 THAs. The mean reported follow-up ranged from 4.4 to 15.2 years and the mean patients’ age at the time of THA from 26 to 50 years. Four studies specified the type of implants used, with 62% being uncemented, 24% hybrid (uncemented cup/cemented stem) and 14% cemented. All but three studies reported the mean survival of implants that ranged from 64.9% to 94.8%. A limited number of complications were mentioned. There was a tendency for more favorable functional outcomes in modern studies. Modern THA-studies in SCFE patients showed improvement of survivorship, clinical outcomes and patient satisfaction. Future higher-quality studies are necessary to estimate long-term postoperative outcomes better.

Total Hip Replacement in Chronic Slipped Capital Femoral Epiphysis with Degenerative Joint Disease: A Case Report

“…In SCFE, the epiphysis, or head of the femur slips down and backwards off the neck of the bone at the growth plate. SCFE is the most common hip disorder affecting the adolescent population, with a reported annual incidence of 8.8 to 10.8 per 100,000 children aged 9 to 16 years [1,2] . SCFE is known to affect boys more often than girls.…”

“…Slipped capital femoral epiphysis (SCFE) is the most common hip disorder affecting the adolescent population, with a reported annual incidence of 8.8 to 10.8 per 100,000 children aged 9 to 16 years [1,2] . SCFE is known to affect boys more often than girls.…”

“…It is believed that the etiology is multifactorial and may include obesity, trauma, and, less frequently, endocrine pathologies comprising hypothyroidism, hypogonadism, and panhypopituitarism. It is a Salter-Harris type I fracture characterized by slippage through the hypertrophic zone of the upper femoral epiphysis such that the femoral head remains in the acetabulum and the neck is displaced anteriorly and externally rotated [2] . SCFE patients may develop early degenerative joint disease secondary to abnormal joint kinematics or femoral acetabular impingement.…”

“…Total Hip Arthroplasty (THA) is the primary treatment option for managing end-stage hip Osteoarthritis (OA) in SCFE patients. However, patients with SCFE represent a minority group among those treated with primary THA [2] . We did a total hip arthroplasty on a 22 years old male with chronic slipped capital femoral epiphysis with early degenerative joint disease.…”

Slipped Capital Femoral Epiphysis in Adolescents: Functional Outcomes and Return to Physical Activity after Surgical Treatment

“…There have been a few studies that examined the impact of age in adolescents with SCFE, surgically treated with PIS, in predicting symptomatic FAI and therefore, worse functional outcomes (10)(11)(12). Most of them showed that age >12 years might be associated with an elevated risk, although this result exhibited only a tendency.…”