Acetabular Morphology in Slipped Capital Femoral Epiphysis: Comparison at Treatment Onset and Skeletal Maturity

Overview

Journal J Child Orthop

Publisher Sage Publications

Specialty Pediatrics

Date 2018 Oct 9

PMID 30294368

Citations 6

Authors

D A Maranho

A Davila-Parrilla

P E Miller

Y-J Kim

E N Novais

M B Millis

Affiliations

Soon will be listed here.

Abstract

Purpose: To investigate changes in acetabular morphology during the follow-up of slipped capital femoral epiphysis (SCFE) and search for factors associated with acetabular dysplasia at skeletal maturity.

Methods: We evaluated 108 patients with unilateral SCFE (mean age at slip, 12.3 years sd 1.7) to skeletal maturity, with a minimum follow-up of two years (median 4.5 years; interquartile range 3.2 to 6.2). Acetabular parameters obtained from initial and most recent radiographs included the lateral centre-edge angle (LCEA), Tönnis angle (TA) and acetabular depth-width ratio (ADR). Acetabular dysplasia was considered for LCEA < 20° or TA > 10°. Femoral parameters consisted of the most recent head diameter, neck-shaft angle, neck length, articulotrochanteric distance and alpha angle.

Results: At SCFE onset, the affected hip showed a slightly lower LCEA (26.4° sd 6.1° 27.3° sd 5.7°; p = 0.01) and ADR (330 sd 30 340 sd 30; p < 0.001) compared with the uninvolved hip. At final follow-up, the affected hip showed lower LCEA (24.5° sd 7.6° 28.8°sd 6.6°; p < 0.001) and ADR (330 sd 40 350 sd 40; p < 0.001), and TA was larger (5.5° sd 5.4° 2.3° sd 4.2°; p < 0.001) compared with the uninvolved hip. Acetabular dysplasia was observed in 27 (25%) of 108 hips with SCFE. Femoral head overgrowth, age at slip and SCFE severity were independent factors associated with acetabular dysplasia (p < 0.05).

Conclusion: Acetabular coverage and depth are not increased in SCFE, and the acetabular coverage tends to decrease up to skeletal maturity. A potential disturbance in the acetabular growth and remodelling exists mainly for young children with severe SCFE, and a potential for acetabular insufficiency may be observed at the diagnosis and follow-up of SCFE.

Level Of Evidence: Prognostic Level IV.

Citing Articles

Changing Treatment Philosophy of Slipped Capital Femoral Epiphysis (SCFE) after Introduction of the Modified Dunn Procedure (MDP): Our Experience with MDP and Its Complications.

Micciulli E, Ruzzini L, Gorgolini G, Costici P, De Maio F, Ippolito E Children (Basel). 2023; 10(7).

PMID: 37508660 PMC: 10378264. DOI: 10.3390/children10071163.

Examining delays in diagnosis for slipped capital femoral epiphysis from a health disparities perspective.

Purcell M, Reeves R, Mayfield M PLoS One. 2022; 17(6):e0269745.

PMID: 35749448 PMC: 9231816. DOI: 10.1371/journal.pone.0269745.

Acetabular retroversion is prevalent and proportional to the severity of slipped upper femoral epiphysis.

Buddhdev P, Vallim F, Slattery D, Balakumar J Bone Jt Open. 2022; 3(2):158-164.

PMID: 35176875 PMC: 8886321. DOI: 10.1302/2633-1462.32.BJO-2021-0189.R1.

Is a Femoro-Acetabular Impingement Type Cam Predictable after Slipped Capital Femoral Epiphysis?.

Wirries N, Heinrich G, Derksen A, Budde S, Floerkemeier T, Windhagen H Children (Basel). 2021; 8(11).

PMID: 34828705 PMC: 8623557. DOI: 10.3390/children8110992.

Which anatomical conditions are associated with limitations of the hip function after SCFE?.

Wirries N, Heinrich G, Derksen A, Schwarze M, Budde S, Windhagen H J Orthop. 2021; 26:94-97.

PMID: 34341629 PMC: 8318912. DOI: 10.1016/j.jor.2021.07.011.

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