Abstract
(1) Background: Previous studies have proven a high incidence of a femoro-acetabular impingement (FAI) type cam in patients sustaining a slipped capital femoral epiphysis (SCFE). Thus, the current study analyzed, if a cam deformity is predictable after SCFE treatment; (2) Methods: 113 cases of SCFE were treated between 1 January 2005 and 31 December 2017. The radiological assessment included the slip angle after surgery (referenced to the femoral neck (epiphyseal tilt) and shaft axis as Southwick angle) and the last available lateral center edge angle (LCEA), the acetabular- and alpha angle. A correlation was performed between these parameters and the last alpha angle to predict a FAI type cam; (3) Results: After a mean follow-up of 4.3 years (±1.9; 2.0–11.2), 48.5% of the patients showed a FAI type cam and 43.2% a dysplasia on the affected side. The correlation between the epiphyseal tilt and alpha angle was statically significant (p = 0.017) with a medium effect size of 0.28; (4) Conclusions: The postoperative posterior epiphyseal tilt was predictive factor to determine the alpha angle. However, the cut-off value of the slip angle was 16.8° for a later occurrence of a FAI type cam indicating a small range of acceptable deviations from the anatomical position for SCFE reconstruction.
Highlights
The slipped capital femoral epiphysis (SCFE) is a hip disorder in the immature skeleton with an incidence between 0.33–24.85/100,000 [1]
In most cases the capital femoral epiphysis slides from the metaphysis in a medial-posterior direction, but lateral-posterior displacements are described [2]
R describes the the correlation between femoral neck axis definedThe with three circles along femoral neck, both whichever fitted values, which was categorized according to Cohen: 0–0.3 small; 0.3–0.8 medium; >0.8 the bony neck best (Figures 1 and 2)
Summary
The slipped capital femoral epiphysis (SCFE) is a hip disorder in the immature skeleton with an incidence between 0.33–24.85/100,000 [1]. While an atypical type is caused by a known trigger including endocrine disorders, renal osteodystrophy or radiation treatment, the majority is idiopathic and only associated with general risk factors, especially obesity [3,4]. Independent of the chosen procedure, the overall aim is to restore and stabilize the anatomical position of the capital femoral epiphysis as close to natural as possible to achieve a physiological femoral neck junction and reduce the risk for osteonecrosis of the femoral head. A remaining incongruence and a remodeling process after the slip and the following treatment may cause a femoro-acetabular impingement (FAI) type cam in the early adolescence.
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