Slipped Capital Femoral Epiphysis: Prevalence, Pathogenesis, and Natural History

Novais, Eduardo N.; Millis, Michael B.

doi:10.1007/s11999-012-2452-y

Cited by 133 publications

(107 citation statements)

References 71 publications

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“…Contemporary goals of surgical treatment of severe SCFE beyond stabilization of the physis include realignment of the proximal femur to restore the femoral head-neck anatomy and allow for better arc of hip motion, thereby avoiding FAI [27,28]. Corrective osteotomies performed at the subcapital level have the advantage of complete restoration of the femoral anatomy but are associated with potential risk of osteonecrosis of the femoral head [11,12].…”

Section: Introductionmentioning

confidence: 99%

Modified Dunn Procedure is Superior to In Situ Pinning for Short-term Clinical and Radiographic Improvement in Severe Stable SCFE

Novais

Hill

Carry

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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100

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Background In situ pinning is the conventional treatment for a stable slipped capital femoral epiphysis (SCFE). However, with a severe stable SCFE the residual deformity may lead to femoroacetabular impingement and articular cartilage damage. A modified Dunn subcapital realignment procedure has been developed to allow for correction at the level of the deformity while preserving the blood supply to the femoral head. Questions/purposes We compared children with severe stable SCFE treated with the modified Dunn procedure or in situ pinning in terms of (1) proximal femoral radiographic deformity; (2) Heyman and Herndon clinical outcome; (3) complication rate; and (4) number of reoperations performed after the initial procedure. Methods In this nonmatched retrospective study, 15 patients treated with the modified Dunn procedure (between 2007 and 2012) and 15 treated with in situ pinning (between 2001 and 2009) for severe but stable SCFE were followed for a mean of 2.5 years (range, 1-6 years). During the period in question, the decision regarding which procedure to use was based on the on-call surgeon's discretion; six surgeons performed in situ pinning and three surgeons performed the modified Dunn procedure. A total of 15 other patients were treated for the same diagnosis during the study period but were lost to followup before 1 year; of those, 12 were in the in situ pinning group. Radiographs were reviewed to measure the AP and lateral alpha angles, femoral head-neck offset, and Southwick angle preoperatively and at the latest clinical visit. The Heyman and Herndon clinical outcome, complications, and subsequent hip surgeries were recorded. Results At latest followup, the median AP alpha angle (52°, range 41°-59°versus 76°, interquartile range [IQR]: 68°-

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Section: Introductionmentioning

confidence: 99%

Modified Dunn Procedure is Superior to In Situ Pinning for Short-term Clinical and Radiographic Improvement in Severe Stable SCFE

Novais

Hill

Carry

et al. 2015

Clinical Orthopaedics &Amp; Related Research

Self Cite

100

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“…Excess weight places stress on the joints and quickly wears down the cartilage. Numerous studies have reported that CD is more severe and occurs more frequently in obese adult female populations compared to ageand gender-matched (female) normal weight groups (24)(25)(26). Felson (27) found that age-matched elderly obese women had greater progression of knee OA compared to women of a normal weight, which was proposed to be due to abnormal mechanical stress of the knee joint.…”

Section: Discussionmentioning

confidence: 99%

Severity and distribution of cartilage damage and bone marrow edema in the patellofemoral and tibiofemoral joints in knee osteoarthritis determined by MRI

Dong

Kong²,

Zhang

et al. 2017

Experimental and Therapeutic Medicine

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Abstract. The aim of the present study was to analyze the distribution and severity of cartilage damage (CD) and bone marrow edema (BME) of the patellofemoral and tibiofemoral joints (PFJ and TFJ, respectively) in patients with knee osteoarthritis (OA), and to determine whether a correlation exists between BME and CD in knee OA, using magnetic resonance imaging (MRI). Forty-five patients diagnosed with knee OA (KOA group) and 20 healthy individuals (control group) underwent sagittal multi-echo recalled gradient echo sequence scans, in addition to four conventional MR sequence scans. Knee joints were divided into 15 subregions by the whole-organ MRI scoring method. MRIs of each subregion were analyzed for the presence of CD, CD score and BME score. The knee joint activity functional score was determined using the Western Ontario and McMaster Universities Arthritis Index (WOMAC) in the KOA group. Statistical analyses were used to compare the CD incidence; CD score and BME score between the PFJ and TFJ. Whether a correlation existed among body mass index, BME score, WOMAC pain score and CD score was also examined. Among the 675 subregions analyzed in the KOA group, 131 exhibited CD (CD score, 1-6). These 131 subregions were primarily in the PFJ (80/131, 61.07%), with the remainder in the TFJ (51/131, 38.93%). Thirty-three subregions had a CD score of 1, including 24 PFJ subregions (72.73%) and 9 TFJ subregions (27.27%). Among the 103 subregions with BME, the PFJ accounted for 60 (58.25%) and the TFJ for 43 (41.75%). A significant positive correlation was found between the BME and CD scores. In conclusion, CD and BME occurred earlier and more often in the PFJ compared to the TFJ in knee OA, and BME is an indirect sign of CD.

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“…Hip X-rays help in diagnosis. If the X-ray is suggestive of SCFE, an immediate orthopedic consult should be sought 24 ( Figure 5). …”

Section: Othermentioning

confidence: 99%

Diagnostic Approach to Limp in Children

Shah¹,

Indra²,

Kannikeshwaran³

et al. 2015

Pediatr Ann

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Abstract"Limp" is a common complaint of children presenting to the emergency department or physician's office. For most patients presenting with limp, the diagnosis and management can be completed in the physician's office or emergency department by gathering a detailed history, performing a careful physical examination, and requesting a few laboratory and imaging studies. This article reviews common causes of atraumatic limp in children and discusses the evaluation and management of these conditions. [Pediatr Ann. 2015;44(12):548-550, 552-554, 556.]

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Slipped Capital Femoral Epiphysis: Prevalence, Pathogenesis, and Natural History

Cited by 133 publications

References 71 publications

Modified Dunn Procedure is Superior to In Situ Pinning for Short-term Clinical and Radiographic Improvement in Severe Stable SCFE

Modified Dunn Procedure is Superior to In Situ Pinning for Short-term Clinical and Radiographic Improvement in Severe Stable SCFE

Severity and distribution of cartilage damage and bone marrow edema in the patellofemoral and tibiofemoral joints in knee osteoarthritis determined by MRI

Diagnostic Approach to Limp in Children

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