Natural History of Untreated Chronic Slipped Capital Femoral Epiphysis

Carney, Brian T.; Weinstein, Stuart L.

doi:10.1097/00003086-199601000-00006

Cited by 131 publications

(45 citation statements)

References 31 publications

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“…Several studies with followup periods between 31 and 41 years have suggested low rates of osteoarthrosis and functional disability [3,7,8]. Consistent with these reports, some surgeons advocate in situ pinning alone for mild SCFE [2,20].…”

Section: Introductionmentioning

confidence: 80%

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In Situ Pinning With Arthroscopic Osteoplasty for Mild SCFE: A Preliminary Technical Report

Leunig

Horowitz

Männer

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Section: Introductionmentioning

confidence: 80%

“…Based on favorable outcomes from long-term studies [3,7,8], the standard treatment for mild SCFE has become in situ pinning. More recently, this protocol has been called into question by reports that even mild slips may lead to early acetabular labrum and cartilage damage [10,12,17].…”

Section: Discussionmentioning

confidence: 99%

In Situ Pinning With Arthroscopic Osteoplasty for Mild SCFE: A Preliminary Technical Report

Leunig

Horowitz

Männer

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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show abstract

“…Our data are to some extent comparable to findings of other studies. At a mean follow-up of 41 years, Carney and Weinstein [21] noted evidence of joint degeneration in 63% where mild epiphyseal slip was evident at surgery and degeneration was apparent in all hips with moderate and severe epiphyseal slip. Hägglund et al [22] noted OA in 24-53% at follow-up of 28 years after pinning in situ in 157 hips.…”

Section: Discussionmentioning

confidence: 99%

Significance of clinical and radiographic findings in young adults after slipped capital femoral epiphysis

Zilkens

Bittersohl

Jäger

et al. 2010

International Orthopaedics (SICOT)

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The purpose of this study was to assess the clinical and radiographic presentation of young adults in the mid-term follow-up after pinning in situ for mild to moderate slipped capital femoral epiphysis (SCFE). We postulated that there was a correlation between the degree of head-neck-offset decrease and clinical and radiographic signs of hip joint degeneration. Thirty-eight young adults (average age 23.4±3.6 years old) with various grades of femoral head-neck-offset pathologies were assessed clinically via Harris hip score (HHS), Tegner-Lysholm score (TLS) and Short Form 36 (SF-36), and radiographic signs of OA were measured on plain X-ray films after a follow-up of 11.1±3.8 years. We conclude that clinical and radiographic signs of joint degeneration appear early in the follow-up after SCFE, but there is no linear correlation between offset-pathology and joint degeneration.

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“…Greater displacement in patients with SCFE predicts the development of osteoarthritis [9,10,15,50]. Therefore, to prevent further slip progression, surgical fixation of the epiphysis is the recommended primary treatment [2,4,16,34,38,51].…”

Section: Introductionmentioning

confidence: 99%

Clinical Stability of Slipped Capital Femoral Epiphysis does not Correlate with Intraoperative Stability

Ziebarth

Domayer

Slongo

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background The most important objective of clinical classifications of slipped capital femoral epiphysis (SCFE) is to identify hips associated with a high risk of avascular necrosis (AVN) -so-called unstable or acute slips; however, closed surgery makes confirmation of physeal stability difficult. Performing the capital realignment procedure in SCFE treatment we observed that clinical estimation of physeal stability did not always correlate with intraoperative findings at open surgery. This motivated us to perform a systematic comparison of the clinical classification systems with the intraoperative observations. Questions/purposes We asked: (1) Is the classification of an acute versus chronic slip based on the duration of symptoms sensitive and specific in detecting intraoperative disrupted physes in patients with SCFE? (2) Is the stable/ unstable classification system based on clinical symptoms sensitive and specific in detecting intraoperative disrupted physes in patients with SCFE? Methods We retrospectively reviewed 82 patients with SCFE treated by open surgery between 1996 and 2009. We classified the clinical stability of all hips using the classifications based on onset of symptoms and on function. We classified intraoperative stability as intact or disrupted. We determined the sensitivity and specificity of two classification systems to determine intraoperative stability. Results Complete physeal disruption at open surgery was seen in 28 of the 82 hips (34%). With classification as acute, acute-on-chronic, and chronic, the sensitivity for disrupted physes was 82% and the specificity was 44%. With the classification of Loder et al., the values were 39% and 76%, respectively. Conclusion Current clinical classification systems are limited in accurately diagnosing the physeal stability in SCFE.

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Natural History of Untreated Chronic Slipped Capital Femoral Epiphysis

Cited by 131 publications

References 31 publications

In Situ Pinning With Arthroscopic Osteoplasty for Mild SCFE: A Preliminary Technical Report

In Situ Pinning With Arthroscopic Osteoplasty for Mild SCFE: A Preliminary Technical Report

Significance of clinical and radiographic findings in young adults after slipped capital femoral epiphysis

Clinical Stability of Slipped Capital Femoral Epiphysis does not Correlate with Intraoperative Stability

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