Open reduction of the severely slipped upper femoral epiphysis

Abstract

The results of open reduction of the severely slipped upper femoral epiphysis are reported for 1 15 hips with an average follow-up of 12 years 11 months (range 2 to 33 years). In 70 hips with a chronic slip and an open growth plate the incidence of complications was low: two developed avascular necrosis, five chondrolysis, and one had both. There were more complications in the 38 hips with an acute-on-chronic slip: six developed avascular necrosis, one chondrolysis, and three had both. Of the seven hips operated upon with a partially fused plate, only one did well. All these complications were obvious within the first year but there were also three hips in the series in which osteoarthritis developed between 10 and 20 years after operation.

High Survivorship and Little Osteoarthritis at 10-year Followup in SCFE Patients Treated With a Modified Dunn Procedure

“…4). Others have reported comparable results with 3% of OA at a mean 13-year followup using the original Dunn reduction procedure in a publication of its originator [10]. Using the cuneiform neck osteotomy, OA at a mean 13-year followup was found in 9% of the hips [21].…”

“…In these two studies, each study reported one hip converting to THA at short-term followup of 2 years (percentage of conversion to THA of 2% and 7%) [52,56]. With a minimal 10-year followup, other studies reported on a rate of conversion to THA after subcapital osteotomies ranging from 1% to 11% [6,10,50,71,72] (mean followup ranging from 10 to 16 years) and from 0% to 13% for intertrochanteric osteotomies (mean followup ranging from 19 to 24 years) [24,57,69]. Carney et al [12] evaluated several surgical treatments for hips with SCFE including in situ pinning and hips without surgical treatment and found a conversion to THA in 37% at a mean followup of 41 years.…”

Joint Chondrolysis

“…Cases of chondrolysis after the placement of implants for periarticular soft-tissue or fracture fixation, a history of joint trauma, and surgical insult with or without improper techniques have been reported across all joints [1][2][3]13,[14][15][16][17][18][19][20][21][22][23][24][25][26][27][31][32][33][34][35][45][46][47][48]51,[53][54][55][56][57][58][59][60][61][63][64][65][66]69,70,[72][73][74][75][76][77][78][79]…”

Current concepts in the treatment of adolescent femoroacetabular impingement

“…basi-cervical and sub-capital), the greater the potential for correction of chronic slip deformity in SCFE [56]; however, there is an increased risk of osteonecrosis and chondrolysis [57]. For example, osteonecrosis has been reported to occur at a rate of 10-100 % [58][59][60].…”