Intertrochanteric Imhäuser osteotomy combined with osteochondroplasty in treatment of moderate-severe stable slipped capital femoral epiphysis: a case series study

Abdelaziz, Tarek Hassan; Elbeshry, Shady Samir; Goda, Ayman Hussein; Fayyad, Tamer A; Aly, Ahmad Saeed; Mahmoud, Shady

doi:10.1097/bpb.0000000000000683

Cited by 5 publications

(4 citation statements)

References 24 publications

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“…Our study showed that hip arthroscopy along with the McMaster osteotomy can be safely performed under the same anesthesia for treatment of concomitant labral tears. Studies suggest that combined open osteochondroplasty and intertrochanteric osteotomy (ITO) via surgical hip dislocation may produce better patient-reported outcomes compared to ITO alone in correcting SCFE deformities and associated FAI [ 28 ]. However, surgical hip dislocation requires a larger incision, increases surgical complexity and increases risk of AVN.…”

Section: Discussionmentioning

confidence: 99%

The McMaster osteotomy—a novel surgical treatment to chronic slipped capital femoral epiphysis: description of surgical technique and case study

Li,

Qiu,

Khurshed

et al. 2023

Journal of Hip Preservation Surgery

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Slipped capital femoral epiphysis (SCFE) is a common adolescent hip disorder that can lead to complex proximal femur deformities and devastating consequences such as avascular necrosis, femoroacetabular impingement syndrome and early-onset osteoarthritis. Existing surgical techniques are often insufficient to fully address the constellation of multiplanar deformities in patients with severe SCFE. Therefore, the McMaster Osteotomy, a novel intertrochanteric proximal femur osteotomy, was developed to improve anatomic correction and hip mechanics in patients with chronic SCFE. The McMaster Osteotomy was implemented in two patients (A: 16-year-old male, B: 17-year-old female) with proximal femur deformities due to chronic SCFE. Surgical planning was facilitated with a 3D-printed pelvic model generated from a CT scan of a patient with the SCFE deformity. Patient B also underwent concurrent arthroscopic osteochondroplasty and labral repair. Pre- and post-operative function and radiographic measurements were recorded. Post-operatively, patient A’s neck-shaft angle improved from 125° to 136°, Southwick angle from 52° to 33°, neck length from 66 mm to 80 mm and hip internal rotation from 5° to 25°. Patient B’s post-operative neck-shaft angle improved from 122° to 136°, Southwick angle from 25° to 15°, neck length from 76 mm to 84 mm, hip internal rotation from 5° to 20° and alpha angle from 87.6° to 44.3°. Both patients are pain-free and have obtained full union of their osteotomies. The McMaster Osteotomy is a versatile technique that can produce a more anatomic reconstruction of hip anatomy and restoration of abductor mechanics. As an extracapsular technique, the risk of femoral head avascular necrosis is minimized.

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Section: Discussionmentioning

confidence: 99%

The McMaster osteotomy—a novel surgical treatment to chronic slipped capital femoral epiphysis: description of surgical technique and case study

Li,

Qiu,

Khurshed

et al. 2023

Journal of Hip Preservation Surgery

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“…Extracapsular base of neck osteotomy has been associated with 86% of satisfactory results, according to a modified Southwick criteria. 22 It has been suggested that osteoplasty in association with compensating Imhäuser osteotomy improves clinical outcomes, 19,29 showing greater Non-Arthritic Hip Scores in comparison with hips without osteoplasty. 15 Range of motion was mostly restored to near normal levels following the osteotomy at the base of the neck with osteoplasty, except for increased internal rotation.…”

Section: Discussionmentioning

confidence: 99%

“…Extracapsular base of neck osteotomy has been associated with 86% of satisfactory results, according to a modified Southwick criteria. ( 22 It has been suggested that osteoplasty in association with compensating Imhäuser osteotomy improves clinical outcomes, ( 19 ), ( 29 showing greater Non-Arthritic Hip Scores in comparison with hips without osteoplasty. ( 15…”

Section: Discussionmentioning

confidence: 99%

Osteotomy at the Base of Femoral Neck and Osteoplasty for the Treament of Scfe

et al. 2022

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Objective: To compare the clinical outcomes between patients with moderate and severe slipped capital femoral epiphysis (SCFE) treated with osteotomy at the base of neck and osteoplasty and with healthy individuals. Methods: Comparative cohort with 12 patients (14 hips) with moderate and severe SCFE who underwent osteotomy at the base of neck and osteoplasty between 2007 and 2014. The mean age at surgery was 13.3 ± 2.5 years and the mean follow-up was 3.8 ± 2.2 years. We assessed the level of hip pain by the visual analog scale (VAS) and anterior impingement test (AIT); the level of function using the Harris Hip Score (HHS) and 12-Item Short Form Health Survey (SF-12), the range of motion (ROM) by goniometry and Drehmann sign, and the hip muscular strength by isokinetic and Trendelenburg sign. Results: The level of pain was slightly higher in the SCFE cohort compared with healthy hips (VAS, 0.8 ± 1.4 vs 0 ± 0, 0.007; AIT, 14% vs 0%, p = 0.06; respectively). No differences were observed between the SCFE and control cohort for the functional scores (HHS, 94 ± 7 vs 100 ± 1, p = 0.135); except for ROM, with increased internal rotation (37.3º ± 9.4º vs 28.7º ± 8.2º, p < 0.001), and strength, with decreased abduction torque (75.5 ± 36.9 Nm/Kg vs 88.5 ± 27.6 Nm/Kg, p = 0.045) in the SCFE cohort. Conclusion: The osteotomy at the base of neck and the osteoplasty restored the hip motion and muscle strength, except for the abductor strength, to near normal levels, representing a viable option for the treatment of moderate and severe SCFE. Level of Evidence III, Ambidirectional Cohort Study.

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“…Some recent papers suggested to improve Imhauser osteotomy by performing a neck osteochondroplasty through a surgical dislocation approach. They considered this procedure safe and effective in 62 hips with severe stable SCFE after a mean follow-up of 4.1 years [43][44][45]. However, in a previous 24 years long term follow-up study in which SCFE were treated by Imhauser osteotomy, the incidence of osteoarthritis was high (45%) [46].…”

Section: Main Textmentioning

confidence: 99%

Surgical treatment of slipped capital femoral epiphysis (SCFE) by Dunn procedure modified by Ganz: a systematic review

Gorgolini

Caterini

Efremov

et al. 2022

BMC Musculoskelet Disord

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Background Treatment of SCFE is still controversial, especially in moderate and severe forms. Dunn osteotomy performed with the Ganz approach became very popular in the last decade, although it is a complicated and challenging surgical procedure with a risk of AVN. The aim of our study was to analyze the current literature verifying the effectiveness of this surgical procedure, with specific attention to the incidence of AVN and other complications. Main body A systematic review on the subject was performed according to the PRISMA guidelines. A literature search was performed by searching all published articles about the topic in the databases. The articles were screened for the presence of the following inclusion criteria: patients affected by slipped capital femoral epiphysis (SCFE) surgically treated by Dunn osteotomy using the Ganz surgical approach. All the patients affected by pathologies other than SCFE, treated without surgery or with procedures not including a surgical hip dislocation were excluded. Based on inclusion and exclusion criteria, 23 studies were included in our systematic review. Selected articles were published from 2009 to 2021 and they included 636 overall hips. According to the selected articles, Dunn osteotomy modified by Ganz, performed by an experienced surgeon, allows for anatomical reduction of moderate or severe SCFE with a low incidence of AVN. Conclusions The few papers with long term follow-up, reported no progression of hip osteoarthritis, however, since the patients are adolescent at surgery, longer follow-up studies are needed to validate this statement. It is still debated if better results are obtained in stable or unstable SCFE. The indication of this procedure in mild SCFE remains controversial. Level of evidence 3

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Intertrochanteric Imhäuser osteotomy combined with osteochondroplasty in treatment of moderate-severe stable slipped capital femoral epiphysis: a case series study

Cited by 5 publications

References 24 publications

The McMaster osteotomy—a novel surgical treatment to chronic slipped capital femoral epiphysis: description of surgical technique and case study

The McMaster osteotomy—a novel surgical treatment to chronic slipped capital femoral epiphysis: description of surgical technique and case study

Osteotomy at the Base of Femoral Neck and Osteoplasty for the Treament of Scfe

Surgical treatment of slipped capital femoral epiphysis (SCFE) by Dunn procedure modified by Ganz: a systematic review

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