Bilateral Total Hip Replacement for Slipped Capital Femoral Epiphysis in a Young Adult After Growth Hormone Therapy:...

We present the case of a 26-year-old male who developed bilateral slipped capital femoral epiphysis (SCFE) as a complication of recombinant human growth hormone (rhGH) therapy and was treated with a two-stage bilateral total hip replacement (THR). Growth hormone deficiency was due to a craniopharyngioma, for which curative neurosurgical excision led to panhypopituitarism requiring lifelong hormone replacement and continuation of rhGH therapy. The patient reported bilateral groin pain for two years before presentation; symptoms were initially attributed to short stature and spinal issues, resulting in delayed diagnosis. On presentation, there were clear signs of severe bilateral SCFE, confirmed by radiographs and CT. After shared decision-making, the patient underwent staged bilateral THR, beginning with the left hip. The case illustrates that, with advances in surgical technique and prosthetic materials, THR can be a viable option for young adults with severe SCFE, even when bilateral. It underscores the need for vigilance in monitoring patients on rhGH, particularly those with hypopituitarism, for SCFE, and highlights the importance of multidisciplinary care across endocrinology, neurosurgery, and orthopedic management.