Abstract
PurposeMild slipped capital femoral epiphyses (SCFE) nevertheless show significant femoral head–neck deformities which may put cartilage and acetabular labrum at risk. Whether this deformity can be restored to normal has not yet been described in the literature.MethodsIn a prospective follow-up study, 14 patients with mild SCFE underwent in situ fixation with a single 6.5-mm cancellous, partially threaded screw. In 14 patients arthroscopic osteochondroplasty was performed, and in 13 patients pre- and postoperative measurements of the α-angle were made using antero-superior radial magnetic resonance imaging.ResultsAfter arthroscopic osteochondroplasty, the mean α-angle decreased from 57° (range 50°–74°) to 37° (range 32°–47°; p < 0.001). Six patients showed beginning degenerative intra-articular changes (four antero-superior cartilage and three antero-superior labrum lesions) at the time of hip arthroscopy. No intra-operative complications occurred. In one patient, arthroscopic debridement was necessary due to arthrofibrosis and persistent pain.ConclusionArthroscopic osteochondroplasty can successfully correct the antero-superior α-angle in patients with mild SCFE to normal values. Clinical randomized controlled studies with long-term follow-up are required to find evidence of improved functional and radiographic mid- and long-term outcome compared to in situ fixation alone.
Highlights
Slipped capital femoral epiphysis (SCFE) mainly occurs in young teenage boys, and is associated with overweight and endocrine disorders [1]
Arthroscopic osteochondroplasty can successfully correct the antero-superior a-angle in patients with mild slipped capital femoral epiphyses (SCFE) to normal values
SCFE is defined by a dorso-medial slippage of the proximal femoral epiphysis, leading to a change in the femoral head–neck axis, a femoro-acetabular pressure area and a consecutive femoral head–neck deformity antero-laterally
Summary
Slipped capital femoral epiphysis (SCFE) mainly occurs in young teenage boys, and is associated with overweight and endocrine disorders [1]. SCFE is defined by a dorso-medial slippage of the proximal femoral epiphysis, leading to a change in the femoral head–neck axis, a femoro-acetabular pressure area and a consecutive femoral head–neck deformity antero-laterally. Goodman et al [3] found a strong correlation between post-slip morphology (pistol-grip and femoral head tilt deformity) and osteoarthritis. He described ‘‘anterior flattening of the acetabulum, cystic degeneration in the anterior metaphyseal-epiphyseal region, and progression to global osteoarthritis’’. This description corresponds to antero-superior femoro-acetabular impingement (FAI)
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