Trends in slipped capital femoral epiphysis: Is the rate declining?

Gutman, Ilya; Gilbert, Shawn R.

doi:10.1302/1863-2548.12.180081

Cited by 8 publications

(6 citation statements)

References 19 publications

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“…24 Recent studies have suggested a divergent relationship between SCFE incidence and increasing obesity rates. 25,26 Notably, a 27.5% decrease in SCFEs in the U.S. between 1997 and 2012 25 and a 34% decrease in SCFEs in Ontario, Canada, between 2002-2011. 26 The uncertainty around this relationship could be linked to the reliability of direct measurements and reporting of obesity by institutions.…”

Section: Discussionmentioning

confidence: 99%

A New Look on the Epidemiology of Slipped Capital Femoral Epiphysis: A Topic Revisited

Miles,

Wilson,

Scull

et al. 2023

Journal of the Pediatric Orthopaedic Society of North America

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Section: Discussionmentioning

confidence: 99%

A New Look on the Epidemiology of Slipped Capital Femoral Epiphysis: A Topic Revisited

Miles,

Wilson,

Scull

et al. 2023

Journal of the Pediatric Orthopaedic Society of North America

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“…Several studies report a decline in the incidence of SCFE[ 10 - 12 ]. As obesity rates have been increasing, it is unusual for fewer children to suffer from SCFE.…”

Section: Discussionmentioning

confidence: 99%

Comparing complications of outpatient management of slipped capital femoral epiphysis and Blount’s disease: A database study

Jardaly¹,

Torrez²,

McGwin³

et al. 2022

WJO

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BACKGROUND Currents trends in pediatric orthopaedics has seen an increase in surgeries being successfully completed in an outpatient setting. Two recent examples include slipped capital femoral epiphysis (SCFE) and Blount’s disease. Surgical indications are well-studied for each pathology, but to our knowledge, there is an absence in literature analyzing safety and efficacy of inpatient vs outpatient management of either condition. We believed there would be no increase in adverse outcomes associated with outpatient treatment of either conditions. AIM To investigate whether outpatient surgery for SCFE and Blount’s disease is associated with increased risk of adverse outcomes. METHODS The 2015-2017 American College of Surgeons National Surgical Quality Improvement Program Pediatric Registries were used to compare patient characteristics, rates of complications, and readmissions between outpatient and inpatient surgery for SCFE and Blount’s disease. RESULTS Total 1788 SCFE database entries were included, 30% were performed in an outpatient setting. In situ pinning was used in 98.5% of outpatient surgeries and 87.8% of inpatient surgeries ( P < 0.0001). Inpatients had a greater percent of total complications than outpatients 2.57% and 1.65% respectively. Regarding Blount’s disease, outpatient surgeries constituted 41.2% of the 189 procedures included in our study. The majority of inpatients were treated with a tibial osteotomy, while the majority of outpatients had a physeal arrest ( P < 0.0001). Complications were encountered in 7.4% of patients, with superficial surgical site infections and wound dehiscence being the most common. 1.6% of patients had a readmission. No differences in complication and readmission risks were found between inpatients and outpatients. CONCLUSION The current trend is shifting towards earlier discharges and performing procedures in an outpatient setting. This can be safely performed for a large portion of children with SCFE and Blount’s disease without increasing the risk of complications or readmissions. Osteotomies are more commonly performed in an inpatient setting where monitoring is available.

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“…Two recent studies have demonstrated a reduction in SUFE incidence in the United States and Canada. 41,42 Both studies concluded the reasons for this are unclear, and further epidemiological studies are required to determine if this is reflected in other geographical regions. Larger cohort studies are currently underway, specifically the United Kingdom-based British Orthopaedic Surgery Surveillance on SUFE, 43 and whilst the results of this study are yet to published, it will be interesting to see how our national data of Northern Ireland compares with a large prospective longitudinal cohort study.…”

Section: Discussionmentioning

confidence: 99%

Temporal changes in slipped upper femoral epiphysis at a regional level: A declining incidence and literature review

Tucker¹,

Ballard²,

Cosgrove³

2019

Journal of Children's Orthopaedics

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Purpose Slipped upper femoral epiphysis (SUFE) is one of the most common adolescent hip pathologies in children with potential for life-long morbidity secondary to avascular necrosis (AVN). The primary aim is to determine an up-to-date demographic of SUFE, as well as current trends in presentation and radiological characteristics. Secondary aims are to quantify prophylactic fixation and subsequent contralateral SUFE. Methods Between 01 January 2013 and 31 December 2015, all cases of SUFE were identified in Northern Ireland. Patient demographics, slip characteristics and outcomes are presented and the incidence rates were calculated using census data. Temporal changes in incidence, compared with a previous cohort, are demonstrated. Results A total of 56 patients (80 hips) were identified. Based on census data, SUFE incidence has declined from 7.14 to 4.69/100,000 population aged < 16 years. Male cases predominated by > 2:1 ratio, and tended to be older than female cases. Approximately 75% of patients were above the 75th centile for age-sex adjusted body weight. Knee pain as a presenting symptom led to a delay in diagnosis. Prophylactic fixation was performed in 25.9%, with contralateral slips occurring in 27.5%. AVN occurred in 7.4% and remained static. Conclusion The incidence of SUFE has declined ~34% in our region. When SUFE occurs, knee pain often results in a delay in definitive diagnosis, and commands clinical vigilance to avoid delays in diagnosis. Patients in our region should be aware of a 1-in-4 contralateral slip rate. Overall, AVN rates remain static and are acceptable, despite the declining incidence of SUFE. Level of evidence Level III - Retrospective Cohort Study

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Trends in slipped capital femoral epiphysis: Is the rate declining?

Cited by 8 publications

References 19 publications

A New Look on the Epidemiology of Slipped Capital Femoral Epiphysis: A Topic Revisited

A New Look on the Epidemiology of Slipped Capital Femoral Epiphysis: A Topic Revisited

Comparing complications of outpatient management of slipped capital femoral epiphysis and Blount’s disease: A database study

Temporal changes in slipped upper femoral epiphysis at a regional level: A declining incidence and literature review

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