Long-term outcomes of slipped capital femoral epiphysis treated with in situ pinning

Poorter, Jolanda J. de; Beunder, Tom J.; Gareb, Barzi; Oostenbroek, Hubert J.; Bessems, Gert H. J. M.; Lugt, J. C. T. van der; Maathuis, Patrick G. M.; Sande, M. A. J. van der

doi:10.1007/s11832-016-0759-z

Cited by 36 publications

(48 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…8 This method’s reliability in stopping the progression of a slip has been shown in long-term studies; 9 however, one could hypothesise the risk of abductor weakness due to relative trochanter overgrowth. It may therefore be preferable to stabilise SCFEs with an implant that allows further growth.…”

Section: Introductionmentioning

confidence: 99%

Biomechanical considerations in slipped capital femoral epiphysis and insights into prophylactic fixation

Leblanc

Bellemore

Cheng

et al. 2017

Journal of Children's Orthopaedics

View full text Add to dashboard Cite

PurposeSlipped capital femoral epiphysis (SCFE) is a deformity of the proximal femur secondary to widened and unstable physis. In stabilising the slip, gold standard treatments stop growth and involve premature physeal closure, which prevents the remodelling of the acquired deformity and creates a leg length discrepancy that may be significant in younger patients.MethodsWe measured the impact of placing threaded screws across the proximal femoral physis by measuring the centre-trochanteric distance (CTD) and articulo-trochanteric distance (ATD) in participants with or without prophylactic fixation. We then compared the mechanical performance of static (stainless and titanium cannulated Synthes screws) and potentially growing implants (Synthes SCFE screw and Pega Medical Free Gliding screw) in a validated synthetic bone model.ResultsIn the review of 30 non-fixed and 60 fixated hips over a mean follow-up of 1.9 years, we have noted a significant difference in pre/post CTD and ATD, as well as the change in CTD and ATD over time. In the biomechanical study, the newer implants allowing growth (Synthes SCFE screw and Pega Medical Free Gliding screw) were both shown to be at least non-inferior.ConclusionsThe primary deformity of a SCFE in itself alters hip mechanics. Also, as confirmed in this study, there is a secondary deformity that is created by static fixation and relative trochanteric overgrowth. To help remodel mild deformities and prevent secondary trochanteric overgrowth, growing implants seem to be non-inferior to the more standard means of fixation in static testing.

show abstract

Section: Introductionmentioning

confidence: 99%

Biomechanical considerations in slipped capital femoral epiphysis and insights into prophylactic fixation

Leblanc

Bellemore

Cheng

et al. 2017

Journal of Children's Orthopaedics

View full text Add to dashboard Cite

show abstract

“…They concluded that there was no association between higher slip angle and poor outcome. Poorter et al 28 looked more specifically at hip function in a group of 61 patients with a mean follow-up of 18.4 years. Their cohort reported lower scores for QOL and sports activities.…”

Section: Discussionmentioning

confidence: 99%

Long-term hip function in slipped capital femoral epiphysis treated with in situ pinning

Bond

Phillips

Larsen

et al. 2019

J Orthop Surg (Hong Kong)

View full text Add to dashboard Cite

Background: In recent years, there has been a trend toward more aggressive management of slipped capital femoral epiphysis (SCFE) with acute anatomical realignment; however, the literature is unclear with regard to the indications for this. Questions/purposes: To collect long-term patient-reported outcome scores on a group of SCFE patients using modern hip scores. The second aim was to determine whether there is a threshold level of deformity beyond which patients have predictably poor outcomes following in situ pinning. Patients and methods: Patients presenting with SCFE between 2000 and 2009 completed a survey consisting of three modern hip scores and were classified into poor, intermediate, and good outcome groups. The posterior slope angle (PSA) was used to measure slip deformity. We examined the relationship between patient characteristics and functional outcomes. The relationship between PSA score and overall outcome was examined using receiver operator curve (ROC) analysis. Results: The total study population was 63; 14% patients had poor, 29% had intermediate, and 57% had good functional outcomes. The mean Non-Arthritic Hip Scores (NAHSs) for those with poor outcomes was 51, 76 in the intermediate group, and 95 in the good group (p <0.001). PSA was significantly lower in those with good functional outcomes. ROC analysis demonstrated that a higher PSA was moderately predictive of a poor clinical outcome (area under the curve of 0.668). In both the poor and intermediate outcome groups, 50% of patients had a PSA of 40 or greater, whereas only 31% of those with good clinical outcomes had PSA of 40 or greater. Conclusions: A significant proportion of post-SCFE patients have ongoing suboptimal hip function after pinning in situ. Those with a PSA more than 40 have a higher chance of a poor outcome.

show abstract

“…Six studies (324 hips) provided useful data on the rate of FAI [ 43 , 46 , 57 , 58 , 70 , 71 ]. These studies investigated pinning in situ, physeal osteotomy and Ganz surgical dislocation.…”

Section: Discussionmentioning

confidence: 99%

Treatment of stable slipped capital femoral epiphysis: systematic review and exploratory patient level analysis

et al. 2017

View full text Add to dashboard Cite

Background Several aspects of slipped capital femoral epiphysis (SCFE) treatment remain controversial. Loder's work has been instrumental in changing our understanding and approach to the management of the condition when he introduced the concept of ''slip instability'' and showed that avascular necrosis (AVN) developed in 47% of unstable slips but none of the stable slips. As the two types of SCFE behave differently in terms of presentation, progress and complications, we approached them as two different conditions to highlight these differences. This paper focuses on treatments of stable SCFE. Materials and methods An extensive literature search was carried out from multiple databases. One thousand six hundred and twenty-three citations were screened. Three hundred and sixteen full publications were obtained for further scrutiny. Fifty-eight studies (2262 hips) were included in the review. These studies evaluated 6 interventions. AVN was chosen as a surrogate for bad outcome. Secondary outcomes were chondrolysis (CL), femoro-acetabular impingement (FAI), osteoarthritis (OA) and patients' reported outcomes. The latter were pooled when they met our predefined criteria. Results The type of surgical intervention was an important risk factor. Pinning in situ (PIS) was associated with the lowest AVN rate (1.4%). Moreover, the CL, FAI and OA rates were relatively low in patients who underwent PIS.

show abstract

Long-term outcomes of slipped capital femoral epiphysis treated with in situ pinning

Cited by 36 publications

References 20 publications

Biomechanical considerations in slipped capital femoral epiphysis and insights into prophylactic fixation

Biomechanical considerations in slipped capital femoral epiphysis and insights into prophylactic fixation

Long-term hip function in slipped capital femoral epiphysis treated with in situ pinning

Treatment of stable slipped capital femoral epiphysis: systematic review and exploratory patient level analysis

Contact Info

Product

Resources

About