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01-03-2014 | Original Paper

Subclinical bilateral involvement of the hip in patients with slipped capital femoral epiphysis—a multicentre study

Authors: Yusuke Kohno, Yasuharu Nakashima, Toshio Kitano, Tomoyuki Nakamura, Kazuyuki Takamura, Mio Akiyama, Daisuke Hara, Takuaki Yamamoto, Goro Motomura, Masanobu Ohishi, Satoshi Hamai, Iwamoto Yukihide

Published in: International Orthopaedics | Issue 3/2014

Abstract

Purpose

This study was conducted to assess the posterior inclination of the contralateral femoral epiphysis in patients with unilateral slipped capital femoral epiphysis (SCFE).

Methods

The posterior sloping angle (PSA) was measured using lateral radiographs in 67 patients with a unilateral SCFE and in 41 age-matched normal controls. A symptomatic epiphyseal slip was defined as the development of SCFE.

Results

The contralateral PSA in SCFE patients was more widely distributed and significantly larger compared to controls (15.0° vs. 9.0°, p < 0.0001). Forty-seven hips (70.1 %) had a PSA of greater than 12.8°, which was +2SD of the control hips. Of the 65 hips excluding the two cases with prophylactic pinning, 11 hips (16.9 %) eventually developed a contralateral SCFE during adolescence and their PSA at the initial visit was significantly larger compared to patients without a contralateral SCFE (18.0° vs. 14.3°, p < 0.005) with a cutoff value of 19°.

Conclusions

These findings suggested the possibility of bilateral hip involvement in SCFE patients. Hips with greater degrees of PSA (> 19°) are likely to become symptomatic.

Hägglund G, Hansson LI, Ordeberg G, Sandstrøm S (1988) Bilaterality in slipped upper femoral epiphysis. J Bone Joint Surg Br 70(2):179–181PubMed

Jerre R, Billing L, Hansson G, Karlsson J, Wallin J (1996) Bilaterality in slipped capital femoral epiphysis: importance of a reliable radiographic method. J Pediatr Orthop B 5:80–84PubMedCrossRef

Carney BT, Weinstein SL, Noble J (1991) Long-term follow-up of slipped capital femoral epiphysis. J Bone Joint Surg Am 73(5):667–674PubMed

Zilkens C, Bittersohl B, Jäger M, Miese F, Schultz J, Kircher J, Westhoff B, Krauspe R (2011) Significance of clinical and radiographic findings in young adults after slipped capital femoral epiphysis. Int Orthop 35(9):1295–1301PubMedCentralPubMedCrossRef

Seller K, Wild A, Westhoff B, Raab P, Krauspe R (2006) Clinical outcome after transfixation of the epiphysis with Kirschner wires in unstable slipped capital femoral epiphysis. Int Orthop 30(5):342–347PubMedCentralPubMedCrossRef

Jensen HP, Steinke MS, Mikkelsen SS, Thomsen PB (1990) Hip physiolysis. Bilaterality in 62 cases followed for 20 years. Acta Orthop Scand 61:419–420PubMedCrossRef

Loder RT, Aronson DD, Greenfield ML (1993) The epidemiology of bilateral slipped capital femoral epiphysis. A study of children in Michigan. J Bone Joint Surg Am 75(8):1141–1147PubMed

Aronsson DD, Loder RT, Breur GJ, Weinstein SL (2006) Slipped capital femoral epiphysis: current concepts. J Am Acad Orthop Surg 14(12):666–679PubMed

Schultz WR, Weinstein JN, Weinstein SL, Smith BG (2002) Prophylactic pinning of the contralateral hip in slipped capital femoral epiphysis: evaluation of long-term outcome for the contralateral hip with use of decision analysis. J Bone Joint Surg Am 84-A(8):1305–1314PubMed

10.

Jerre T (1950) Study in slipped upper femoral epiphysis: with special reference to late functional and roentogenological results and to value of closed reduction. Acta Orthop Scand Suppl 6:3–15

11.

Klein A, Joplin RJ, Reidy JA, Hanelin J (1953) Management of the contralateral hip in slipped capital femoral epiphysis. J Bone Joint Surg Am 35-A(1):81–87PubMed

12.

Hägglund G (1996) The contralateral hip in slipped capital femoral epiphysis. J Pediatr Orthop B 5(3):158–161PubMedCrossRef

13.

Billing L, Severin E (1959) Slipping epiphysis of the hip. A roentgenological and clinical study based on a new roentgen technique. Acta Radiol Suppl 174:1–76PubMed

14.

Loder RT, Wittenberg B, DeSilva G (1995) Slipped capital femoral epiphysis associated with endocrine disorders. J Pediatr Orthop 15(3):349–356PubMedCrossRef

15.

Loder RT, Hensinger RN (1997) Slipped capital femoral epiphysis associated with renal failure osteodystrophy. J Pediatr Orthop 17(2):205–211PubMedCrossRef

16.

Barrios C, Blasco MA, Blasco MC, Gascó J (2005) Posterior sloping angle of the capital femoral physis: a predictor of bilaterality in slipped capital femoral epiphysis. J Pediatr Orthop 25(4):445–449PubMedCrossRef

17.

Zenios M, Ramachandran M, Axt M, Gibbons PJ, Peat J, Little D (2007) Posterior sloping angle of the capital femoral physis: interobserver and intraobserver reliability testing and predictor of bilaterality. J Pediatr Orthop 27(7):801–804PubMedCrossRef

18.

Park S, Hsu JE, Rendon N, Wolfgruber H, Wells L (2010) The utility of posterior sloping angle in predicting contralateral slipped capital femoral epiphysis. J Pediatr Orthop 30(7):683–689PubMedCrossRef

19.

Phillips PM, Phadnis J, Willoughby R, Hunt L (2013) Posterior sloping angle as a predictor of contralateral slip in slipped capital femoral epiphysis. J Bone Joint Surg Am 95(2):146–150PubMed

20.

Loder RT, Richards BS, Shapiro PS, Reznick LR, Aronson DD (1993) Acute slipped capital femoral epiphysis: the importance of physeal stability. J Bone Joint Surg Am 75(8):1134–1140PubMed

21.

Jerre R, Billing L, Hansson G, Wallin J (1994) The contralateral hip in patients primarily treated for unilateral slipped upper femoral epiphysis. Long-term follow-up of 61 hips. J Bone Joint Surg Br 76(4):563–567PubMed

22.

Hansson LI, Hägglund G, Ordeberg G (1987) Slipped capital femoral epiphysis in southern Sweden 1910–1982. Acta Orthop Scand Suppl 226:1–67PubMedCrossRef

23.

Castro FP Jr, Bennett JT, Doulens K (2000) Epidemiological perspective on prophylactic pinning in patients with unilateral slipped capital femoral epiphysis. J Pediatr Orthop 20(6):745–748PubMedCrossRef

24.

Akiyama M, Nakashima Y, Kitano T, Nakamura T, Takamura K, Kohno Y, Yamamoto T, Motomura G, Ohishi M, Hamai S, Iwamoto Y (2013) Remodelling of femoral head-neck junction in slipped capital femoral epiphysis: a multicentre study. Int Orthop. doi:10.1007/s00264-013-2047-6

25.

Kandzierski G, Matuszewski L, Wójcik A (2012) Shape of growth plate of proximal femur in children and its significance in the aetiology of slipped capital femoral epiphysis. Int Orthop 36(12):2513–2520PubMedCentralPubMedCrossRef

26.

Westhoff B, Ruhe K, Weimann-Stahlschmidt K, Zilkens C, Willers R, Krauspe R (2012) The gait function of slipped capital femoral epiphysis in patients after growth arrest and its correlation with the clinical outcome. Int Orthop 36(5):1031–1038PubMedCentralPubMedCrossRef

27.

Hurley JM, Betz RR, Loder RT, Davidson RS, Alburger PD, Steel HH (1996) Slipped capital femoral epiphysis. The prevalence of late contralateral slip. J Bone Joint Surg Am 78(2):226–230PubMed

Title: Subclinical bilateral involvement of the hip in patients with slipped capital femoral epiphysis—a multicentre study
Authors: Yusuke Kohno
Yasuharu Nakashima
Toshio Kitano
Tomoyuki Nakamura
Kazuyuki Takamura
Mio Akiyama
Daisuke Hara
Takuaki Yamamoto
Goro Motomura
Masanobu Ohishi
Satoshi Hamai
Iwamoto Yukihide
Publication date: 01-03-2014
Publisher: Springer Berlin Heidelberg
Published in: International Orthopaedics / Issue 3/2014
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-013-2131-y

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Subclinical bilateral involvement of the hip in patients with slipped capital femoral epiphysis—a multicentre study

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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