Management of the contralateral hip in patients with unilateral slipped upper femoral epiphysis

Hansson, Göran; Nathorst-Westfelt, J.

doi:10.1302/0301-620x.94b5.28322

Cited by 20 publications

(19 citation statements)

References 34 publications

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“…Nonetheless, accuracy and predictability of assessing 3D deformity with single radiographic views has been questioned . Position‐dependency and limitations by pain may interfere with obtaining frog lateral radiographs . Thus, advanced imaging has been pursued in an attempt to characterize more thoroughly and reliably the complex deformity in SCFE hips.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Three‐Dimensional Translational and Angular Deformity in Slipped Capital Femoral Epiphysis

Bland

Valdovino

Jeffords

et al. 2019

Journal Orthopaedic Research

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The purpose of this study was to quantify three-dimensional translational and angular deformity (defined as theta) present at the proximal femoral physis in slipped capital femoral epiphysis (SCFE), and to use theta to differentiate between SCFE hips, contralateral unaffected hips, and normal hips by comparing to the current gold standard measure of the Southwick slip angle (SSA). 3DCT reconstructions of the pelvis and femur in SCFE patients and normal adolescents were obtained and pelvic position was standardized. The center point and direction vector of the femoral epiphysis was determined. The femoral neck axis was defined. The angle between the femoral neck axis and epiphysis vector defined the 3D angle of deformity (theta). The 3D translation of the femoral epiphysis, measured as a percentage of femoral neck diameter, was measured in three planes. The average theta angle was significantly greater in SCFE hips (46.5 ± 24.3°) compared with control (13.7 ± 6.4°) or normal (11.7 ± 3.7°) hips (p < 0.001). There was no significant difference in theta angle between control and normal hips (p = 0.468). Theta angle correlated strongly with SSA (r s = 0.737, p < 0.001). Statement of clinical significance: The proximal femoral deformity in patients with slipped capital femoral epiphysis can be defined by measuring displacement of the epiphysis in all three dimensions in relation to the femoral neck axis. This information can be used in epiphyseal reorientation surgery to ensure anatomic reduction. The similarity between control and normal hips may argue against the thought that there is pre-existing deformity in a pre-slip condition of unaffected contralateral hips in SCFE patients.

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Section: Discussionmentioning

confidence: 99%

Evaluation of the Three‐Dimensional Translational and Angular Deformity in Slipped Capital Femoral Epiphysis

Bland

Valdovino

Jeffords

et al. 2019

Journal Orthopaedic Research

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“…Moreover, with continued growth there is a risk that the anchorage in the epiphysis will be lost and repeat fixation will be required. Further growth of the femoral neck is less likely to occur if a screw is inserted in compression mode with the head abutting the lateral femoral cortex, causing physiodesis [ 73 ]. Three studies [ 23 , 54 , 55 ] showed that screws with special design allowed growth to continue; however, these were small studies (37 patients) with no comparator.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2017

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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.

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“…In around 30% of patients with SUFE the contralateral hip also becomes involved over time and fixing the other hip prophylactically (figure 3) is often favoured 3. Uncertainty exists about future growth, as fixing the contralateral hip may result in leg length discrepancy due to epiphysiodesis effect.…”

Section: Descriptionmentioning

confidence: 99%

Hashimoto's hypothyroidism presenting with SUFE (slipped upper femoral epiphysis)

2014

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Management of the contralateral hip in patients with unilateral slipped upper femoral epiphysis

Cited by 20 publications

References 34 publications

Evaluation of the Three‐Dimensional Translational and Angular Deformity in Slipped Capital Femoral Epiphysis

Evaluation of the Three‐Dimensional Translational and Angular Deformity in Slipped Capital Femoral Epiphysis

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

Hashimoto's hypothyroidism presenting with SUFE (slipped upper femoral epiphysis)

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