Document Detail

Increased acetabular depth may influence physeal stability in slipped capital femoral epiphysis.
MedLine Citation:
PMID:  23354466     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Multiple mechanical factors affecting the hip have been associated with the development of slipped capital femoral epiphysis (SCFE). Whether acetabular depth plays a role in the development of a SCFE has not been elucidated.
QUESTIONS/PURPOSES: (1) What is the prevalence of a deep acetabulum in SCFE? (2) Is the presence of a deep acetabulum associated with physeal instability? (3) Is the presence of a deep acetabulum associated with the occurrence of a contralateral SCFE?
METHODS: We retrospectively reviewed 232 patients (156 males) who presented with a unilateral SCFE. Fifty (22%) subsequently developed a contralateral SCFE. The involved and uninvolved sides were evaluated for the presence of a deep acetabulum (DA). Preoperative radiographic parameters, slip stability, development of a contralateral SCFE, and demographic factors were then compared between patients with and without DA.
RESULTS: DA was present in 120 hips (52%) with a SCFE. DA was more common in females (55 of 76 [72%]) than males (65 of 156 [42%]). Patients with DA presented with a higher lateral center-edge angle (33° versus 31°), slip angle (52° versus 43°), and with a lower body mass index (28.1 versus 30.0 kg/m(2)). Increased acetabular depth was more common in patients with an unstable SCFE (29 of 41 [71%]) than those with a stable SCFE (91 of 191 [48%]). The presence of DA either on the affected side or the contralateral side did not predict a contralateral SCFE.
CONCLUSIONS: Despite not predicting a contralateral SCFE, DA may influence physeal stability if a SCFE does develop. Therefore, the contralateral hip with DA should be closely monitored.
LEVEL OF EVIDENCE: Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.
David A Podeszwa; David Gurd; Anthony Riccio; Adriana De La Rocha; Daniel J Sucato
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Publication Detail:
Type:  Journal Article     Date:  2013-01-26
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:  2151-5     Citation Subset:  AIM; IM    
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MeSH Terms
Acetabulum / physiopathology,  radiography*
Biomechanical Phenomena
Disease Progression
Hip Joint / physiopathology,  radiography*
Range of Motion, Articular
Retrospective Studies
Risk Factors
Slipped Capital Femoral Epiphyses / etiology*,  physiopathology,  radiography

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