Good long-term outcome of the untreated contralateral hip in unilateral slipped capital femoral epiphysisReportar como inadecuado




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Journal of Children-s Orthopaedics

, Volume 8, Issue 5, pp 367–373

Forty hips with a mean follow-up of 41 yearsFirst Online: 30 September 2014Received: 13 July 2014Accepted: 10 September 2014

Abstract

PurposeThere is no consensus regarding prophylactic fixation of the contralateral hip in slipped capital femoral epiphysis SCFE. In order to further study this question, we evaluated the long-term natural history of untreated contralateral hips.

MethodsForty patients treated for unilateral SCFE without evidence of subsequent contralateral slip during adolescence were reviewed with a mean follow-up of 36 years range 21–50 years. The deformity after SCFE may demonstrate radiographic signs of cam-type femoroacetabular impingement. We, therefore, measured α-angles in the contralateral hips on anteroposterior AP and frog-leg lateral radiographs. The angles were compared with those of a control group of adults without SCFE. Five years after the radiographic examination, with a mean follow-up of 41 years, all patients were evaluated by telephone interview. As range of motion and deformity could not be examined, a modified Harris hip score HHS maximum score of 91 points was used. A modified HHS <76 points and-or radiographic osteoarthritis OA was classified as a poor long-term outcome.

ResultsThe mean value of the AP α-angle was significantly higher in the contralateral hips in SCFE patients than in the control group 55° vs. 46°, while the mean value of the lateral α-angle was not. Abnormally high values for one or both α-angles were found in 16 contralateral hips 40 %, of which five patients had abnormal values for both α-angles and were considered to have had an asymptomatic contralateral slip. Five patients 13 % had a poor outcome in the contralateral hip, of which three patients 8 % had OA. There was a significant association between hips with both α-angles that were abnormal and poor outcome.

ConclusionsSince the natural history showed good long-term radiographic and clinical outcome in 35 of 40 patients and only three had OA, we conclude that routine prophylactic fixation of the contralateral hip is not indicated.

KeywordsPaediatric Hip Slipped capital femoral epiphysis Contralateral Prophylactic fixation α-Angle  Download fulltext PDF



Autor: Anders Wensaas - Ragnhild B. Gunderson - Svein Svenningsen - Terje Terjesen

Fuente: https://link.springer.com/



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