Document Detail

The fate of hips that are not prophylactically pinned after unilateral slipped capital femoral epiphysis.
MedLine Citation:
PMID:  23283674     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The indications for prophylactic pinning of the contralateral hip after unilateral slipped capital femoral epiphysis (SCFE) remain controversial in part because the natural history of the contralateral hip is unclear.
QUESTIONS/PURPOSES: We therefore determined (1) the incidence of contralateral slips in patients with unilateral SCFE, (2) the rate of subsequent corrective surgery, and (3) the Harris hip score (HHS) and VAS pain score for hips that sustained a contralateral slip after unilateral pinning.
METHODS: We retrospectively reviewed 226 patients with unilateral SCFE at initial presentation between 1965 and 2005; of these, 133 met our inclusion criteria and were followed at least 2 years. Latest followup included examination and radiographs for 52 patients and HHS (without radiographs) and VAS pain score for 81 hips. Minimum followup was 2 years (median, 13 years; range, 2-43 years).
RESULTS: Of the 133 patients at risk for a subsequent slip, 20 patients developed a contralateral slip (15%). One patient developed avascular necrosis requiring arthroplasty, and another patient had a mild contralateral slip with disabling pain. For the 15 patients with contralateral slips and scores available, the mean HHS was 90 (range, 49-100) and the mean VAS pain score was 20 of 100. Six found the contralateral hip painful.
CONCLUSIONS: The contralateral slip sustained by the majority of patients was for the most part mild. However, nearly 1/3 of the contralateral slipped hips were painful. One patient has severe pain, and a second required THA for avascular necrosis after an unstable slip. These may have been preventable by prophylactic pinning.
LEVEL OF EVIDENCE: Level III, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.
Yaser M K Baghdadi; A Noelle Larson; Rafael J Sierra; Hamlet A Peterson; Anthony A Stans
Related Documents :
11155544 - Twitch-obtaining intramuscular stimulation (toims): long term observations in the manag...
19171034 - Depression and anxiety as major determinants of neck pain: a cross-sectional study in g...
17171134 - Functional outcomes of the retromaxillary-infratemporal fossa dissection for advanced h...
15288404 - Prognostic factors for neck pain in general practice.
21432564 - Perception of anesthesia safety and postoperative symptoms of surgery patients in ho ch...
18345304 - Recent trends in liver resection surgery activity and population utilization rates in e...
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  471     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2013 Jul 
Date Detail:
Created Date:  2013-06-10     Completed Date:  2013-08-28     Revised Date:  2014-07-01    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2124-31     Citation Subset:  AIM; IM    
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Arthroplasty, Replacement, Hip
Biomechanical Phenomena
Bone Screws*
Chi-Square Distribution
Child, Preschool
Disease Progression
Femur Head Necrosis / etiology,  surgery
Hip Joint / physiopathology,  radiography,  surgery*
Orthopedic Procedures / adverse effects,  instrumentation*
Pain Measurement
Pain, Postoperative / etiology,  surgery
Postoperative Complications / etiology*,  physiopathology,  radiography,  surgery
Range of Motion, Articular
Retrospective Studies
Slipped Capital Femoral Epiphyses / physiopathology,  radiography,  surgery*
Time Factors
Treatment Outcome
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Can joint contact dynamics be restored by anterior cruciate ligament reconstruction?
Next Document:  Tibial tubercle osteotomy or quadriceps snip in two-stage revision for prosthetic knee infection? A ...