Correlation of Functional and Radiological Results with Three-Dimensional Gait Analysis in Patients with Unilateral Slipped Capital Femoral Epiphysis

Abstract

Aim: The aim of this study was to evaluate the correlation between gait analysis and clinical and radiographic results in patients operated for slipped capital femoral epiphysis (SCFE).Materials and Methods: This study included 31 patients with unilateral SCFE. The mean follow-up time was 3.3 ± 1.4 years. Harris hip score (HHS) and the Pediatric Outcomes Data Collection Instruments (PODCI) scores were collected. Slip-angle, alpha-angle, lateral femoral head ratio (LFHR), articulotrochanteric distance (ATD), anteroposterior plane femoral head ratio (AP-FHR), anterior head-neck offset ratio (HNOR), and neck-shaft angle (NSA) were measured. An age-matched control group consisting of 20 healthy individuals was used for comparison. Results: Transfer and basic mobility subscale of PODCI was correlated with pelvis tilt ROM (r = −0.7, p < 0.001), foot progression angle (FPA) ROM (r =−0.4, p=0.02), and mean spine tilt (r=−0.6, p<0.001). FPA was also correlated with the HHS (r=−0.5, p<0.001) and pain/comfort subscale of PODCI (r=−0.5, p=0.015). Significant correlations were detected between LFHR and mean hip flexion (r=−0.5, p<0.001), pelvic tilt (r=−0.4, p=0.04), and mean spine tilt (r=0.6, p<0.001). Correlations between ATD and mean internal rotation of the hip (r=0.5, p=0.03) and mean dorsal ankle extension (r=−0.4, p=0.03) were also significant. No significant correlation was found between the alpha angle, AP-FHR, and HNOR with the kinematic values.Conclusion: Clinical scores of patients treated for SCFE were mostly correlated with pelvic tilt ROM, FPA, and spine tilt. LFHR and ATD were observed as the most critical radiological measurements related to a patient’s gait function.