Slipped Capital Femoral Epiphysis: A Review of the New Zealand Literature.

Abstract

The New Zealand Māori and Pacific ethnicities have the highest burden of slipped capital femoral epiphysis (SCFE) worldwide. Therefore, New Zealand provides a rich and unique therapeutic and research environment for this devastating hip condition. A systematic literature review was performed using MEDLINE, PubMed, and Google Scholar from January 1, 1900, to December 31, 2019, with the following keywords: New Zealand, SCFE, slipped capital femoral epiphysis, SUFE, and slipped upper femoral epiphysis. The references were also screened. Eight original scientific research articles that had been published in peer-reviewed journals were identified, as well as 4 published abstracts from conference proceedings; we summarized the key findings. The New Zealand Māori and Pacific ethnicities have the highest reported burden of SCFE, with 4.2 and 5.6 times the prevalence, respectively, when compared with New Zealand European (Caucasian). Māori children are younger at presentation (p = 0.002) and more frequently present with bilateral SCFE (p = 0.05), and there is a strong link with childhood obesity. A contralateral posterior sloping angle (PSA) of ≥14° may be used as an adjunct threshold for decision-making regarding prophylactic pinning. A PSA of ≥40° was found to correlate with a higher likelihood of unsatisfactory functional outcome following SCFE pinning in situ. When conversion to total hip arthroplasty is eventually required due to SCFE, early functional outcomes are similar to those of patients with primary osteoarthritis, and revision rates and mortality rates are not significantly different. Landmark literature from New Zealand has been published on SCFE management, and there is a promising future of quality, impactful research. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.