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Archives of Orthopaedic and Trauma Surgery
Published in: Archives of Orthopaedic and Trauma Surgery 8/2012

01-08-2012 | Hip Arthroplasty

Outcomes of total hip replacement in patients with slipped capital femoral epiphysis

Authors: Francesco Traina, Marcello De Fine, Caterina Novella Abati, Barbara Bordini, Aldo Toni

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 8/2012

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Abstract

Background

Total hip replacement has been advocated for the treatment of degenerative hip diseases secondary to slipped capital femoral epiphysis; nonetheless, outcomes of this procedure have not been well established. We reviewed the outcomes of modern total hip replacements in patients who suffered from slipped capital femoral epiphysis.

Methods

A retrospective study was carried out on 32 total hip replacements performed on 28 patients who suffered from slipped capital femoral epiphysis from August 1994 to January 2007. The average age at the time of surgery was 45 years. Clinical evaluation was performed using the Harris Hip Score, radiographic assessment measuring cup and stem orientation, the extent of osteolysis around the implant, and leg length discrepancy. The average follow-up was 98 months (range 25–204 months).

Results

Two total hip replacements failed, one for stem aseptic loosening and the other for modular neck failure. The cumulative survival rate at 9 years was 92.8 %. If the end point was revision for implant loosening, the survival rate improved to 96.8 % at 9 years. The only complication recorded was an intraoperative fracture of the lesser trochanter immediately treated with cerclage wire. At the latest follow-up, the Harris Hip Score averaged 86 (range 70–97). Leg length discrepancies greater than 1 cm were present in 18 cases before surgery, and in only 6 cases after surgery.

Discussion

We recommend total hip replacement for patients who suffer from slipped capital femoral epiphysis because of the satisfactory survival, low complication rate, and the possibility of restoring leg length.
Literature
1.
Lehmann CL, Arons RR, Loder RT, Vitale MG (2006) The epidemiology of slipped capital femoral epiphysis: an update. J Pediatr Orthop 26(3):286–290PubMedCrossRef
2.
Murray AW, Wilson NI (2008) Changing incidence of slipped capital femoral epiphysis: a relationship with obesity? J Bone Joint Surg Br 90(1):92–94PubMedCrossRef
3.
Slongo T, Kakaty D, Krause F, Ziebarth K (2010) Treatment of slipped capital femoral epiphysis with a modified Dunn procedure. J Bone Joint Surg Am 92(18):2898–2908PubMedCrossRef
4.
Leunig M, Casillas MM, Hamlet M, Hersche O, Notzli H, Slongo T, Ganz R (2000) Slipped capital femoral epiphysis: early mechanical damage to the acetabular cartilage by a prominent femoral metaphysis. Acta Orthop Scand 71(4):370–375PubMedCrossRef
5.
Fraitzl CR, Kafer W, Nelitz M, Reichel H (2007) Radiological evidence of femoroacetabular impingement in mild slipped capital femoral epiphysis: a mean follow-up of 14.4 years after pinning in situ. J Bone Joint Surg Br 89(12):1592–1596PubMedCrossRef
6.
Gent E, Clarke NM (2004) Joint replacement for sequelae of childhood hip disorders. J Pediatr Orthop 24(2):235–240PubMedCrossRef
7.
Amstutz HC, Su EP, Le Duff MJ (2005) Surface arthroplasty in young patients with hip arthritis secondary to childhood disorders. Orthop Clin North Am 36(2):223–230PubMedCrossRef
8.
Larson AN, McIntosh AL, Trousdale RT, Lewallen DG (2010) Avascular necrosis: most common indication for hip arthroplasty in patients with slipped capital femoral epiphysis. J Pediatr Orthop 30(8):767–773PubMedCrossRef
9.
Abraham E, Gonzalez MH, Pratap S, Amirouche F, Atluri P, Simon P (2007) Clinical implications of anatomical wear characteristics in slipped capital femoral epiphysis and primary osteoarthritis. J Pediatr Orthop 27(7):788–795PubMedCrossRef
10.
Radl R, Hungerford M, Materna W, Rehak P, Windhager R (2005) Higher failure rate and stem migration of an uncemented femoral component in patients with femoral head osteonecrosis than in patients with osteoarthrosis. Acta Orthop 76(1):49–55PubMedCrossRef
11.
Yasunaga Y, Yamasaki T, Matsuo T, Yoshida T, Oshima S, Hori J, Yamasaki K, Ochi M (2011) Clinical and radiographical results of 179 thrust plate hip prostheses: 5–14 years follow-up study. Arch Orthop Trauma Surg (Epub ahead of print)
12.
Kawasaki M, Hasegawa Y, Sakano S, Masui T, Ishiguro N (2005) Total hip arthroplasty after failed transtrochanteric rotational osteotomy for avascular necrosis of the femoral head. J Arthroplast 20(5):574–579CrossRef
13.
Makela KT, Eskelinen A, Pulkkinen P, Paavolainen P, Remes V (2008) Total hip arthroplasty for primary osteoarthritis in patients fifty-five years of age or older. An analysis of the Finnish arthroplasty registry. J Bone Joint Surg Am 90(10):2160–2170PubMedCrossRef
14.
Harris WH (1969) Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am 51(4):737–755PubMed
15.
Herrlin K, Pettersson H, Selvik G (1988) Comparison of two- and three-dimensional methods for assessment of orientation of the total hip prosthesis. Acta Radiol 29(3):357–361PubMed
16.
Engh CA Jr, Culpepper WJ 2nd, Engh CA (1997) Long-term results of use of the anatomic medullary locking prosthesis in total hip arthroplasty. J Bone Joint Surg Am 79(2):177–184PubMedCrossRef
17.
Engh CA, Bobyn JD, Glassman AH (1987) Porous-coated hip replacement. The factors governing bone ingrowth, stress shielding, and clinical results. J Bone Joint Surg Br 69(1):45–55PubMed
18.
Gruen TA, McNeice GM, Amstutz HC (1979) “Modes of failure” of cemented stem-type femoral components: a radiographic analysis of loosening. Clin Orthop Relat Res 141:17–27PubMed
19.
Brooker AF, Bowerman JW, Robinson RA, Riley LH Jr (1973) Ectopic ossification following total hip replacement. Incidence and a method of classification. J Bone Joint Surg Am 55(8):1629–1632PubMed
20.
Atwood SA, Patten EW, Bozic KJ, Pruitt LA, Ries MD (2010) Corrosion-induced fracture of a double-modular hip prosthesis: a case report. J Bone Joint Surg Am 92(6):1522–1525PubMedCrossRef
21.
Wright G, Sporer S, Urban R, Jacobs J (2010) Fracture of a modular femoral neck after total hip arthroplasty: a case report. J Bone Joint Surg Am 92(6):1518–1521PubMedCrossRef
22.
Traina F, De Clerico M, Biondi F, Pilla F, Tassinari E, Toni A (2009) Sex differences in hip morphology: is stem modularity effective for total hip replacement? J Bone Joint Surg Am 91(Suppl 6):121–128PubMedCrossRef
23.
Lewinnek GE, Lewis JL, Tarr R, Compere CL, Zimmerman JR (1978) Dislocations after total hip-replacement arthroplasties. J Bone Joint Surg Am 60(2):217–220PubMed
24.
Johannson HR, Zywiel MG, Marker DR, Jones LC, McGrath MS, Mont MA (2011) Osteonecrosis is not a predictor of poor outcomes in primary total hip arthroplasty: a systematic literature review. Int Orthop 35(4):465–473PubMedCrossRef
25.
Baek SH, Kim SY (2008) Cementless total hip arthroplasty with alumina bearings in patients younger than fifty with femoral head osteonecrosis. J Bone Joint Surg Am 90(6):1314–1320PubMedCrossRef
26.
Kim YH, Choi Y, Kim JS (2010) Cementless total hip arthroplasty with ceramic-on-ceramic bearing in patients younger than 45 years with femoral-head osteonecrosis. Int Orthop 34(8):1123–1127PubMedCrossRef
27.
Thillemann TM, Pedersen AB, Johnsen SP, Soballe K (2008) Implant survival after primary total hip arthroplasty due to childhood hip disorders: results from the Danish Hip Arthroplasty Registry. Acta Orthop 79(6):769–776PubMedCrossRef
28.
Amstutz HC, Ebramzadeh E, Sarkany A, Le Duff M, Rude R (2004) Preservation of bone mineral density of the proximal femur following hemisurface arthroplasty. Orthopedics 27(12):1266–1271PubMed
29.
Kishida Y, Sugano N, Nishii T, Miki H, Yamaguchi K, Yoshikawa H (2004) Preservation of the bone mineral density of the femur after surface replacement of the hip. J Bone Joint Surg Br 86(2):185–189PubMedCrossRef
30.
Bartoníček J, Vávra J, Bartoška R (2011) Operative treatment of avascular necrosis of the femoral head after slipped capital femoral epiphysis. Arch Orthop Trauma Surg 131(4):497–502PubMedCrossRef
Metadata
Title
Outcomes of total hip replacement in patients with slipped capital femoral epiphysis
Authors
Francesco Traina
Marcello De Fine
Caterina Novella Abati
Barbara Bordini
Aldo Toni
Publication date
01-08-2012
Publisher
Springer-Verlag
Published in
Archives of Orthopaedic and Trauma Surgery / Issue 8/2012
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-012-1538-z

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