Document Detail


Slipped capital femoral epiphysis: prevalence, pathogenesis, and natural history.
MedLine Citation:
PMID:  23054509     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Obesity is a risk factor for developing slipped capital femoral epiphysis (SCFE). The long-term outcome after SCFE treatment depends on the severity of residual hip deformity and the occurrence of complications, mainly avascular necrosis (AVN). Femoroacetabular impingement (FAI) is associated with SCFE-related deformity and dysfunction in both short and long term.
QUESTIONS/PURPOSES: We examined obesity prevention, early diagnosis, reducing AVN and hip deformity as strategies to reduce SCFE prevalence, and the long-term outcomes after treatment.
METHODS: A search of the literature using the PubMed database for the key concepts SCFE and treatment, natural history, obesity, and prevalence identified 218, 15, 26, and 49 abstracts, respectively. WHERE ARE WE NOW?: A correlation between rising childhood obesity and increasing incidence of SCFE has been recently reported. Residual abnormal morphology of the proximal femur is currently believed to be the mechanical cause of FAI and early articular cartilage damage in SCFE. WHERE DO WE NEED TO GO?: Reducing the increasing prevalence rate of SCFE is important. Treatment of SCFE should aim to reduce AVN rates and residual deformities that lead to FAI to improve the long-term functional and clinical outcomes. HOW DO WE GET THERE?: Implementing public health policies to reduce childhood obesity should allow for SCFE prevalence to drop. Clinical trials will evaluate whether restoring the femoral head-neck offset to avoid FAI along with SCFE fixation allows for cartilage damage prevention and lower rates of osteoarthritis. The recently described surgical hip dislocation approach is a promising technique that allows anatomic reduction with potential lower AVN rates in the treatment of SCFE.
Authors:
Eduardo N Novais; Michael B Millis
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  470     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-11-08     Completed Date:  2013-01-22     Revised Date:  2013-12-04    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3432-8     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Disease Progression
Early Diagnosis
Femoracetabular Impingement / epidemiology
Femur Head Necrosis / epidemiology
Hip Joint* / pathology,  physiopathology,  surgery
Humans
Incidence
Obesity / epidemiology,  prevention & control
Orthopedic Procedures
Predictive Value of Tests
Prevalence
Prognosis
Risk Factors
Slipped Capital Femoral Epiphyses / diagnosis,  epidemiology*,  physiopathology,  prevention & control,  surgery
Comments/Corrections

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


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