Abstract
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.
Similar content being viewed by others
References
Carney BT, Weinstein SL, Noble J (1991) Long-term follow-up of slipped capital femoral epiphysis. J Bone Joint Surg Am 73:667–674
Oram V (1953) Epiphysiolysis of the head of the femur; a follow-up examination with special reference to end results and the social prognosis. Acta Orthop Scand 23:100–120
Seller K, Wild A, Westhoff B et al (2006) Clinical outcome after transfixation of the epiphysis with Kirschner wires in unstable slipped capital femoral epiphysis. Int Orthop 30:342–347
Velasco R, Schai PA, Exner GU (1998) Slipped capital femoral epiphysis: a long-term follow-up study after open reduction of the femoral head combined with subcapital wedge resection. J Pediatr Orthop B 7:43–52
Beck M, Leunig M, Parvizi J et al (2004) Anterior femoroacetabular impingement: part II. Midterm results of surgical treatment. Clin Orthop Relat Res 67–73
Leunig M, Casillas MM, Hamlet M et al (2000) Slipped capital femoral epiphysis: early mechanical damage to the acetabular cartilage by a prominent femoral metaphysis. Acta Orthop Scand 71:370–375
Harris WH (1986) Etiology of osteoarthritis of the hip. Clin Orthop Relat Res 213:20–33
Stulberg SD, Cordell LD, Harris WH et al (1975) Unrecognized childhood hip disease: a major cause of idiopathic osteoarthitis of the hip. In: St. Louis RL Jr, Mosby CV (eds) Proceedings of the third open scientific meeting of the hip society, pp 212–228
Ganz R, Leunig M, Leunig-Ganz K et al (2008) The etiology of osteoarthritis of the hip: an integrated mechanical concept. Clin Orthop Relat Res 466:264–272
Harris WH (1969) Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am 51:737–755
Tegner Y, Lysholm J (1985) Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res 43–49
Ware JE Jr, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 30:473–483
Tönnis D (1976) Normal values of the hip joint for the evaluation of X-rays in children and adults. Clin Orthop Relat Res 119:39–47
Croft P, Cooper C, Wickham C et al (1990) Defining osteoarthritis of the hip for epidemiologic studies. Am J Epidemiol 132:514–522
Notzli HP, Wyss TF, Stoecklin CH et al (2002) The contour of the femoral head-neck junction as a predictor for the risk of anterior impingement. J Bone Joint Surg Br 84:556–560
Jerre T (1950) A study in slipped capital femoral epiphysis. Acta Orthop Scand 6
Ross PM, Lyne ED, Morawa LG (1979) Slipped capital femoral epiphysis long-term results after 10–38 years. Clin Orthop Relat Res 176–180
Schai PA, Exner GU, Hansch O (1996) Prevention of secondary coxarthrosis in slipped capital femoral epiphysis: a long-term follow-up study after corrective intertrochanteric osteotomy. J Pediatr Orthop B 5:135–143
Zilkens C, Holstein A, Bittersohl B et al (2010) Delayed gadolinium-enhanced magnetic resonance imaging of cartilage in the long-term follow-up after Perthes disease. J Pediatr Orthop 30:147–153
Clohisy JC, Knaus ER, Hunt DM et al (2009) Clinical presentation of patients with symptomatic anterior hip impingement. Clin Orthop Relat Res 467:638–644
Carney BT, Weinstein SL (1996) Natural history of untreated chronic slipped capital femoral epiphysis. Clin Orthop Relat Res 43–47
Hägglund G, Hannson LI, Sandstrom S (1987) Slipped capital femoral epiphysis in southern Sweden. Long-term results after nailing/pinning. Clin Orthop Relat Res 217:190–200
Jerre R, Billing L, Karlsson J (1996) Loss of hip motion in slipped capital femoral epiphysis: a calculation from the slipping angle and the slope. J Pediatr Orthop B 5:144–150
Goodman DA, Feighan JE, Smith AD et al (1997) Subclinical slipped capital femoral epiphysis. Relationship to osteoarthrosis of the hip. J Bone Joint Surg Am 79:1489–1497
Zupanc O, Krizancic M, Daniel M et al (2008) Shear stress in epiphyseal growth plate is a risk factor for slipped capital femoral epiphysis. J Pediatr Orthop 28:444–451
Fishkin Z, Armstrong DG, Shah H et al (2006) Proximal femoral physis shear in slipped capital femoral epiphysis—a finite element study. J Pediatr Orthop 26:291–294
Dudda M, Albers C, Mamisch TC et al (2009) Do normal radiographs exclude asphericity of the femoral head-neck junction? Clin Orthop Relat Res 467:651–659
Acknowledgments
This study was supported by a research grant of the “German Osteoarthritis Aid” (“Deutsche Arthrose-Hilfe e.V.”). We thank Mrs. Kamps for technical support.
Conflict of interest
The authors declare that they have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Zilkens, C., Bittersohl, B., Jäger, M. et al. Significance of clinical and radiographic findings in young adults after slipped capital femoral epiphysis. International Orthopaedics (SICOT) 35, 1295–1301 (2011). https://doi.org/10.1007/s00264-010-1106-5
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00264-010-1106-5