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

Abstract

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.

MRI-based 3D models of the hip joint enables radiation-free computer-assisted planning of periacetabular osteotomy for treatment of hip dysplasia using deep learning for automatic segmentation

“…Mean age was 27 ± 7 years and 52 % were women ( Table 1 ). Of the included 31 hips, 7 hips(23 %) had a cam deformity [ 27 ], 5 hips(16 %) had a pincer deformity ( Table 1 ). Five hips(16 %) had cam deformity combined with decreased femoral version [ 28 ] while 7 hips(23 %) had increased femoral version [ 29 , 30 ].…”

Location of Intra- and Extra-articular Hip Impingement Is Different in Patients With Pincer-Type and Mixed-Type Femoroacetabular Impingement Due to Acetabular Retroversion or Protrusio Acetabuli on 3D CT–Based Impingement Simulation

“…Measurement of femoral torsion was performed on standardized CT scans according to the method described by Lerch et al 24,26 and Murphy et al 35 This CT-based method showed a smaller variability and higher accuracy compared with other measurement methods 49 and compared with biplane radiographs for measurement of femoral torsion. 21 Cam-type deformity was defined as an alpha angle 25,39 greater than 50° on lateral radiographs in the presence of a normal acetabulum 61 (LCEA, 23°-33°). A cam-type deformity was present in 36% of the hips with protrusio acetabuli and in 37% of the hips with acetabular retroversion.…”

Femoroacetabular Impingement Patients With Decreased Femoral Version Have Different Impingement Locations and Intra- and Extraarticular Anterior Subspine FAI on 3D-CT–Based Impingement Simulation: Implications for Hip Arthroscopy

“…Although decreased FV can lead to an extra-articular conflict between the proximal femur and the anterior iliac inferior spine (AIIS) in patients with total hip arthroplasty and bipolar hemiarthroplasty, 47,48 it remains unclear whether the same condition leads to anterior intra-articular impingement, extra-articular subspine impingement, or an aggravation of a concomitant cam-type deformity in the native hip joint. 54,60 Cam-type FAI reduces internal rotation (IR) of the hip, 20,43 typically assessed in 90° of flexion. 60 Decreased FV also impairs IR 62 and thus may lead to anterior FAI in patients with slipped capital femoral epiphysis 20,24,64 and mechanical effect during IR of the hip joint.…”

“…54,60 Cam-type FAI reduces internal rotation (IR) of the hip, 20,43 typically assessed in 90°of flexion. 60 Decreased FV also impairs IR 62 and thus may lead to anterior FAI in patients with slipped capital femoral epiphysis 20,24,64 and mechanical effect during IR of the hip joint. 62,63 Before the early description of FAI, decreased FV was described as a cause for hip pain and osteoarthritis, and rotational osteotomies to increase FV have been performed in adult patients.…”