Mid-term results after in situ pinning and hip arthroscopy for mild slipped capital femoral epiphysis: a minimum five-year follow-up. (2020)

• Record Type: Journal Article
• Authors: Rahm, Stefan; Jud, Lukas; Jungwirth-Weinberger, Anna; Tondelli, Timo; Falkowski, Anna L.; Sutter, Reto; Zingg, Patrick O.
• Is Part Of: Journal of children's orthopaedics. Volume 14:Number 6(2020)
• Page Start: 521
• Page End: 528
• Publication Date: 2020
• Subjects: hip arthroscopy -- slipped capital femoral epiphysis -- CAM impingement -- osteochondroplasty -- magnetic resonance tomography; Pediatric orthopedics -- Periodicals; 618.927005
• DOI: 10.1302/1863-2548.14.200068
• Languages: English
• ISSNs: 1863-2521

Abstract

Abstract: Purpose: In situ pinning of mild slipped capital femoral epiphysis (SCFE) results in an aspherical head–neck junction and arthroscopic osteochondroplasty can successfully correct the head–neck junction. However, whether the correction stays stable over at least five years remains unknown. Methods: In a retrospective and consecutive series, 11 patients with a mean age of 12 years (range, 10 years to 15 years) were included. All patients were treated for mild SCFE with in situ pinning and staged hip arthroscopy correcting the head–neck junction. All patients were assessed clinically and radiographically (radiograph and magnetic resonance imaging (MRI)) pre-operatively, 12 weeks and at least five years' post-operatively. Results: The mean range of motion (ROM) for flexion and internal rotation was stable over time with 100° (sd 4) and 21° (sd 6), respectively at the last follow-up. The mean alpha angle decreased from pre-operative 64° (range 61° to 68°) to 12 weeks post-operative 49° (range 46° to 52°; p = 0.001) and stayed stable over time. New superficial cartilage damage on either the acetabular or femoral side was seen in each three patients. Progressive labral degeneration was present in two patients. Conclusion: In situ pinning and staged hip arthroscopy for the correction of mild SCFE is safe, restores normal alpha angles and reveals stable morphological correction at mid-term follow-up. Furthermore, the clinical results were excellent with almost normalized internal hip rotation at mid-term follow-up in patients who had reached adulthood. However, there was some joint deterioration, but without negative impact on subjective and clinical outcome after at least five years. Level of evidence: IV