The Epidemiology of Slipped Capital Femoral Epiphysis

Lehmann, Charles L.; Arons, R. M.; Loder, Randall T.; Vitale, Michael G.

doi:10.1097/01.bpo.0000217718.10728.70

Cited by 309 publications

(268 citation statements)

References 12 publications

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“…There is also seasonal and geographic variability with higher rates in the north and western parts of the United States [40]. The age of onset of SCFE is approximately 12.7 to 13.5 years for boys and 11.2 to 12 years for girls [40,46]. There is a trend toward onset of SCFE at a younger age compared with previous reports [30,40,61].…”

Section: Search Strategies and Criteriamentioning

confidence: 76%

“…The overall prevalence varies from 0.71 to 10.8 per 100,000 children [33,40,46]. It is known to affect boys more often that girls with a maleto-female ratio of approximately 1.5 [40,46], although unstable slips seem to be at least as common in females as in males. The prevalence of bilateral SCFE has been reported from 20% to 80% and in bilateral cases, the second SCFE usually occurs during the first year after the first slip [49].…”

Section: Search Strategies and Criteriamentioning

confidence: 99%

“…The prevalence of bilateral SCFE has been reported from 20% to 80% and in bilateral cases, the second SCFE usually occurs during the first year after the first slip [49]. There is a racial variability with a higher prevalence rate in blacks, Hispanics, Polynesians, and Native Americans when compared with whites [8,40,46]. There is also seasonal and geographic variability with higher rates in the north and western parts of the United States [40].…”

Section: Search Strategies and Criteriamentioning

confidence: 99%

“…There is a racial variability with a higher prevalence rate in blacks, Hispanics, Polynesians, and Native Americans when compared with whites [8,40,46]. There is also seasonal and geographic variability with higher rates in the north and western parts of the United States [40]. The age of onset of SCFE is approximately 12.7 to 13.5 years for boys and 11.2 to 12 years for girls [40,46].…”

Section: Search Strategies and Criteriamentioning

confidence: 99%

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

Novais

Millis

2012

Clinical Orthopaedics &Amp; Related Research

133

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Background Obesity is a risk factor for developing slipped capital femoral epiphysis (SCFE). The long-term outcome after SCFE treatment depends on the severity of residual hip deformity and the occurrence of complications, mainly avascular necrosis (AVN). Femoroacetabular impingement (FAI) is associated with SCFE-related deformity and dysfunction in both short and long term. Questions/Purposes We examined obesity prevention, early diagnosis, reducing AVN and hip deformity as strategies to reduce SCFE prevalence, and the long-term outcomes after treatment. Methods A search of the literature using the PubMed database for the key concepts SCFE and treatment, natural history, obesity, and prevalence identified 218, 15, 26, and 49 abstracts, respectively. Where Are We Now? A correlation between rising childhood obesity and increasing incidence of SCFE has been recently reported. Residual abnormal morphology of the proximal femur is currently believed to be the mechanical cause of FAI and early articular cartilage damage in SCFE. Where Do We Need to Go? Reducing the increasing prevalence rate of SCFE is important. Treatment of SCFE should aim to reduce AVN rates and residual deformities that lead to FAI to improve the long-term functional and clinical outcomes. How Do We Get There? Implementing public health policies to reduce childhood obesity should allow for SCFE prevalence to drop. Clinical trials will evaluate whether restoring the femoral head-neck offset to avoid FAI along with SCFE fixation allows for cartilage damage prevention and lower rates of osteoarthritis. The recently described surgical hip dislocation approach is a promising technique that allows anatomic reduction with potential lower AVN rates in the treatment of SCFE.

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Section: Search Strategies and Criteriamentioning

confidence: 76%

Section: Search Strategies and Criteriamentioning

confidence: 99%

Section: Search Strategies and Criteriamentioning

confidence: 99%

Section: Search Strategies and Criteriamentioning

confidence: 99%

See 2 more Smart Citations

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

Novais

Millis

2012

Clinical Orthopaedics &Amp; Related Research

133

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“…The etiology remains unclear; however, epidemiologic data for geographic, racial, and seasonal variations suggest that environmental and genetic factors may influence the development of SCFE [4,29]. Rapid growth, obesity, and hormonal disorders have been recognized as risk factors [6,8,19,48].…”

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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Scoliosis Surgery in Children With Neuromuscular Disease

Barsdorf¹,

Sproule²,

Kaufmann³

2010

Arch Neurol

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Background: Scoliosis is a frequent complication of pediatric neuromuscular disease (NMD). Scoliosis surgery in children with NMD is thought to carry greater morbidity and mortality. Objectives: To study demographics, comorbidities, outcomes, and hospitalization expenditures among children with NMD undergoing scoliosis surgery. Design: Using the Kids Inpatient Database, a large allpayer US database of hospital discharges among children and adults younger than 20 years, we studied children undergoing scoliosis surgery between January 1, 1997, and December 31, 2003. Continuous variables were compared by t test, and categorical variables were compared by Pearson product moment correlation 2 test. Setting: National database of pediatric hospital discharges. Patients: Children with and without NMD. Main Outcome Measures: Demographics, hospital length of stay, and in-hospital mortality associated with scoliosis surgery. Results: Of 17 780 reported hospitalizations owing to scoliosis surgery, 437 children (2.5%) had NMD. Compared with children undergoing scoliosis surgery for other indications, children with NMD were more likely to be younger (12.4 vs 14.2 years), male (73.5% vs 38.3%), and insured by Medicaid (35.6% vs 20.3%). Comorbidities that were more common among children with NMD included pulmonary complications (lung disease not classified, pulmonary collapse, pulmonary insufficiency, chronic respiratory failure, and ventilator requirement) and cardiovascular complications (cardiomyopathy, hypotension, and tachycardia). Scoliosis surgery in children with NMD was associated with increased hospital length of stay (10.3 vs 7.7 days) and hospitalization expenditures ($80 251 vs $62 154), and higher in-hospital mortality (1.6% vs 0.2%). Conclusion: Children with NMD have increased hospital length of stay and higher in-hospital mortality associated with scoliosis surgery, highlighting the need for further study of measures that could reduce complications and improve outcomes in this population.

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The Epidemiology of Slipped Capital Femoral Epiphysis

Cited by 309 publications

References 12 publications

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

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

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

Scoliosis Surgery in Children With Neuromuscular Disease

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