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Outcomes after slipped capital femoral epiphysis: a population-based study with three-year follow-up

B Herngren1,2, M Stenmarker2,3, K Enskär4

  • 1Lund University, Department of Clinical Sciences, Lund, Sweden.

Journal of Children'S Orthopaedics
|October 9, 2018
PubMed

Insights

Slipped capital femoral epiphysis (SCFE) treatment outcomes show avascular necrosis (AVN) risk with capital realignment. Rigorous follow-up of both hips is recommended until physeal closure.

Area of Science:

  • Orthopedic surgery
  • Pediatric orthopedics
  • Hip joint biomechanics

Background:

  • Slipped capital femoral epiphysis (SCFE) is a hip condition affecting adolescents.
  • Long-term outcomes of SCFE treatment require further investigation.
  • Understanding risks like avascular necrosis (AVN) is crucial for patient management.

Purpose of the Study:

  • To evaluate three-year outcomes after SCFE treatment.
  • Assess the incidence of AVN, need for subsequent surgery, and hip function.
  • Examine contralateral hip development post-SCFE.

Main Methods:

  • Prospective cohort study of 379 children treated for SCFE (2007-2013).
  • Analysis of 449 SCFE-treated hips and 151 prophylactically fixed hips.
  • Utilized the Barnhöft questionnaire for patient-reported outcome measures (PROMs).

Main Results:

  • AVN developed in 25 of 449 SCFE hips; 6 of 15 hips treated with capital realignment developed AVN.
  • Peri-implant fractures occurred in 5 hips, with technical difficulties noted in 3.
  • Contralateral SCFE developed in 43 of 201 hips; implant extraction was common post-physeal closure.

Conclusions:

  • Fixation in situ remains the preferred primary treatment for SCFE.
  • Prophylactic fixation is safe with correct technique; capital realignment poses an AVN concern.
  • Rigorous follow-up, including PROMs, for both hips until physeal closure is recommended.
Abstract

Keywords:
complicationsoutcomepatient-reported outcome measuresslipped capital femoral epiphysis

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