Is the level of vitamin D deficiency correlated with the severity and bilaterality in slipped capital femoral epiphysis? A case series study

Elbeshry, Shady Samir; Abdelaziz, Tarek Hassan; Aly, Ahmad Saeed; Mahmoud, Shady

doi:10.52628/88.2.8784

Cited by 4 publications

(9 citation statements)

References 19 publications

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“…Our findings on the relationship between obesity and obesity-related comorbid diseases to the development of SCFE add to the existing body of research. Related comorbid diseases, including juvenile diabetes and vitamin D deficiency, have been explored in patients who experienced SCFE 4,17–20 . Vitamin D deficiency has been shown to be common in the SCFE population, yet its significance is still being elucidated 4,17–20 .…”

Section: Discussionmentioning

confidence: 99%

“…There is evidence vitamin D deficiency is common in overweight and obese adolescents; therefore the data suggesting that metabolic derangement coexists with SCFE diagnosis is concordant 21 . The summation of the current literature is for providers to consider vitamin D supplementation in at-risk adolescents, which would also affect patients at risk for developing SCFE 17–21 …”

Section: Discussionmentioning

confidence: 99%

“…Related comorbid diseases, including juvenile diabetes and vitamin D deficiency, have been explored in patients who experienced SCFE. 4,[17][18][19][20] Vitamin D deficiency has been shown to be common in the SCFE population, yet its significance is still being elucidated. 4,[17][18][19][20] In several small cohort studies, the majority of patients with SCFE were vitamin D deficient compared with controls, and treatment of said deficiency is associated with physeal closure.…”

Section: Discussionmentioning

confidence: 99%

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Quantifying Risk Factors for Slipped Capital Femoral Epiphysis and Postslip Osteonecrosis

Zusman,

Goldstein,

Yoo

2023

Journal of Pediatric Orthopaedics

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Background: Slipped capital femoral epiphysis (SCFE) is a disorder of the proximal femoral physis occurring in late childhood and adolescence. Previously postulated risk factors include obesity and endocrinopathies. The purpose of this investigation was to identify risk factors for developing SCFE, as well as postslip osteonecrosis (ON), among the United States pediatric population. Methods: A national database investigation was performed using PearlDiver Technologies, Inc., queried for SCFE and ON using International Classification of Disease codes (2010 to 2020). Regression analyses to determine the risk of developing a SCFE, and ON after a patient has already been diagnosed with a SCFE (“postslip”). Propensity matching between SCFE and control groups generated a pseudo-randomization model to compare the relative risk. Results: There were 11,465 patients with SCFE available in the database, matched with 134,680 controls. After matching, vitamin D deficiency, obesity, hypothyroidism, and growth hormone use were risk factors for developing SCFE [relative risk ranges from 1.42 (95% CI: 1.21-1.39, vitamin D deficiency) to 3.45 (95% CI: 3.33-3.57, obesity)]. ON risk factors were vitamin D deficiency [1.65 (1.26-2.14)] and hypothyroidism [1.49 (1.10-2.07)]. Conclusions: This United States national database study quantified risk factors of developing an SCFE and postslip ON. Obesity is the most significant risk factor for the development of a slip, but not ON. Growth hormone use, hypothyroidism, and vitamin D deficiency are also risk factors for SCFE development, whereas only the latter two were associated with ON. These findings demonstrate the public health implications of obesity and comorbid conditions in pediatric hip pathology. Level of Evidence: Level III.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Quantifying Risk Factors for Slipped Capital Femoral Epiphysis and Postslip Osteonecrosis

Zusman,

Goldstein,

Yoo

2023

Journal of Pediatric Orthopaedics

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“…25,26 In clinical series, some show a correlation between SCFE and vitamin D levels 27,28 whereas others show no correlation. [29][30][31][32] However, there are no definitive, large-size studies demonstrating a significant correlation between SCFE and vitamin D levels compared with the general population.…”

Section: Discussionmentioning

confidence: 99%

Slipped Capital Femoral Epiphysis, Food Deserts, Poverty, and Urban/Rural Residence: Is There a Link?

Luster

Gunderson

Sun

et al. 2022

Journal of Pediatric Orthopaedics

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Background: Childhood obesity is increased in food deserts, a community with little to no access to healthy food. As obesity is associated with slipped capital femoral epiphysis (SCFE), it was the purpose of this study to analyze the prevalence of SCFE patients by food desert location and its interaction with rural/urban location. Methods: A retrospective review of all consecutive patients with idiopathic SCFE treated at our institution over 11 years was performed. From the patient's address, the US Census Bureau tract in which the patient resided was determined. Using the census tract code, it was ascertained if the patient lived in a food desert and urban or rural location. Standard statistical analyses were performed; a P < 0.05 was considered statistically significant. Results: There were 177 SCFE patients: 79 girls, 98 boys, 106, White, and 69 nonWhite. The average age at diagnosis was 12.1 ± 1.7 years, the average symptom duration 4.1 ± 5.1 months, and the average weight percentile 94 ± 10. Of these 177 patients, 26.5% lived in a food desert, which was higher than the expected 17.5% (P = 0.023). Those living in a food desert were more commonly nonWhite (60% vs. 32%, P = 0.0014). There were 25% from rural areas and 75% from urban areas. No rural SCFE patients lived in food deserts whereas 34% of urban patients lived in food deserts. The average poverty rate of the SCFE patient census tracts was 19%, no greater than the expected 15% (P = 0.32). SCFE patients living in rural census tracts had a lower poverty rate (P < 10 -6 ). Conclusions: There is a correlation with the prevalence of SCFE patients by residence in a "food desert", but not with rural/urban locale or poverty status in Indiana. Further research will be needed to see if these findings apply to other states within the United States and other parts of the world. Level of Evidence: III.

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“…Thirty-nine patients with moderate to severe SCFE were assessed for preoperative vitamin D level, and 38 were found to be vitamin D-deficient, although the amount of deficiency was not correlated with slip severity 38 .…”

Section: Hipmentioning

confidence: 99%

What’s New in Pediatric Orthopaedics

Andras

Sanders²,

Goldstein

et al. 2022

Journal of Bone and Joint Surgery

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This pediatric orthopaedic update represents a review of articles predominantly from October 2021 to October 2022. Spine Adolescent Idiopathic ScoliosisAs we strive toward optimal adolescent idiopathic scoliosis treatment that will serve patients well into adulthood, longterm follow-up studies are of particular importance. Lander et al. reported on a series of 134 patients treated with Harrington instrumentation with a minimum 40-year follow-up. Patients with a lowest instrumented vertebra (LIV) at L3 or proximal had a lower likelihood of undergoing additional surgical procedures at 13% compared with patients with an LIV at L4 or distal at 36%, but, aside from this, the groups were similar with regard to health-related quality of life and their scores were not different from normal age-based means 11 . Also encouraging was the report on 115 patients with a 25year follow-up that showed that the serum levels of cobalt and chromium ions were similar in the patients treated with Harrington instrumentation compared with a control group of patients treated with bracing 12 . However, questions with regard to the long-term effect of retained implants continue to generate concern as titanium levels were found to be persistently elevated to 5 times the preoperative level at the 2-year follow-up in a series with more contemporary implants 13 . The impact of this remains unknown but warrants continued study.There remains continued interest in leveraging technology to achieve optimal pedicle screw placement safely and consistently. In a systematic review and meta-analysis by Baldwin et al., screws placed with intraoperative computed tomographic (CT) navigation were determined to be one-third Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJS/H355).

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Is the level of vitamin D deficiency correlated with the severity and bilaterality in slipped capital femoral epiphysis? A case series study

Cited by 4 publications

References 19 publications

Quantifying Risk Factors for Slipped Capital Femoral Epiphysis and Postslip Osteonecrosis

Quantifying Risk Factors for Slipped Capital Femoral Epiphysis and Postslip Osteonecrosis

Slipped Capital Femoral Epiphysis, Food Deserts, Poverty, and Urban/Rural Residence: Is There a Link?

What’s New in Pediatric Orthopaedics

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