Arthroscopic osteochondroplasty in patients with mild slipped capital femoral epiphysis after in situ fixation

Abstract Purpose Mild slipped capital femoral epiphyses (SCFE) nevertheless show significant femoral head–neck deformities which may put cartilage and acetabular labrum at risk. Whether this deformity can be restored to normal has not yet been described in the literature. Methods In a prospective fo...

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Bibliographic Details
Published in:Journal of children's orthopaedics 2016-02, Vol.10 (1), p.25-30
Main Authors: Tscholl, Philippe M., Zingg, Patrick O., Dora, Claudio, Frey, Eric, Dierauer, Stefan, Ramseier, Leonhard E.
Format: Article
Language:English
Subjects:
Arthritis
Cartilage
Debridement
Ethics
Magnetic resonance imaging
Medicine
Medicine & Public Health
Morphology
Original Clinical
Original Clinical Article
Orthopedics
Osteoarthritis
Patients
Pediatrics
Surgeons
Traumatic Surgery
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Summary:Abstract Purpose Mild slipped capital femoral epiphyses (SCFE) nevertheless show significant femoral head–neck deformities which may put cartilage and acetabular labrum at risk. Whether this deformity can be restored to normal has not yet been described in the literature. Methods In a prospective follow-up study, 14 patients with mild SCFE underwent in situ fixation with a single 6.5-mm cancellous, partially threaded screw. In 14 patients arthroscopic osteochondroplasty was performed, and in 13 patients pre- and postoperative measurements of the α-angle were made using antero-superior radial magnetic resonance imaging. Results After arthroscopic osteochondroplasty, the mean α-angle decreased from 57° (range 50°–74°) to 37° (range 32°–47°; p < 0.001). Six patients showed beginning degenerative intra-articular changes (four antero-superior cartilage and three antero-superior labrum lesions) at the time of hip arthroscopy. No intra-operative complications occurred. In one patient, arthroscopic debridement was necessary due to arthrofibrosis and persistent pain. Conclusion Arthroscopic osteochondroplasty can successfully correct the antero-superior α-angle in patients with mild SCFE to normal values. Clinical randomized controlled studies with long-term follow-up are required to find evidence of improved functional and radiographic mid- and long-term outcome compared to in situ fixation alone.
ISSN:1863-2521
1863-2548
DOI:10.1007/s11832-015-0707-3