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Increased Acetabular Depth May Influence Physeal Stability in Slipped Capital Femoral Epiphysis

  • Symposium: Slipped Capital Femoral Epiphysis: Update and Emerging Concepts
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

Multiple mechanical factors affecting the hip have been associated with the development of slipped capital femoral epiphysis (SCFE). Whether acetabular depth plays a role in the development of a SCFE has not been elucidated.

Questions/purposes

(1) What is the prevalence of a deep acetabulum in SCFE? (2) Is the presence of a deep acetabulum associated with physeal instability? (3) Is the presence of a deep acetabulum associated with the occurrence of a contralateral SCFE?

Methods

We retrospectively reviewed 232 patients (156 males) who presented with a unilateral SCFE. Fifty (22%) subsequently developed a contralateral SCFE. The involved and uninvolved sides were evaluated for the presence of a deep acetabulum (DA). Preoperative radiographic parameters, slip stability, development of a contralateral SCFE, and demographic factors were then compared between patients with and without DA.

Results

DA was present in 120 hips (52%) with a SCFE. DA was more common in females (55 of 76 [72%]) than males (65 of 156 [42%]). Patients with DA presented with a higher lateral center-edge angle (33° versus 31°), slip angle (52° versus 43°), and with a lower body mass index (28.1 versus 30.0 kg/m2). Increased acetabular depth was more common in patients with an unstable SCFE (29 of 41 [71%]) than those with a stable SCFE (91 of 191 [48%]). The presence of DA either on the affected side or the contralateral side did not predict a contralateral SCFE.

Conclusions

Despite not predicting a contralateral SCFE, DA may influence physeal stability if a SCFE does develop. Therefore, the contralateral hip with DA should be closely monitored.

Level of Evidence

Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Texas Scottish Rite Hospital for Children, 2222 Welborn Street, Dallas, TX, 75219, USA

    David A. Podeszwa MD, Anthony Riccio MD, Adriana De La Rocha MS & Daniel J. Sucato MD, MS

  2. Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH, 44195, USA

    David Gurd MD

Authors
  1. David A. Podeszwa MD
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  2. David Gurd MD
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  3. Anthony Riccio MD
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  4. Adriana De La Rocha MS
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  5. Daniel J. Sucato MD, MS
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Corresponding author

Correspondence to David A. Podeszwa MD.

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Each author certifies that he or she, or a member of his or her immediate family, has no funding or commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request.

Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

This work was performed at the Texas Scottish Rite Hospital for Children, Dallas, TX, USA.

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Podeszwa, D.A., Gurd, D., Riccio, A. et al. Increased Acetabular Depth May Influence Physeal Stability in Slipped Capital Femoral Epiphysis. Clin Orthop Relat Res 471, 2151–2155 (2013). https://doi.org/10.1007/s11999-013-2807-z

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  • DOI: https://doi.org/10.1007/s11999-013-2807-z

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