Dataset Information

Arthroscopic Subcapital Realignment in Chronic and Stable Slipped Capital Femoral Epiphysis.

ABSTRACT: Stable slipped capital femoral epiphysis (SCFE) is the most common disease in the adolescent hip, with an estimated frequency of 10.8 in every 100,000 individuals. Recent studies of the biomechanics of femoroacetabular impingement indicate that small anatomical deformities of the hip arising from SCFE can potentially cause permanent acetabular chondral damage. There is no consensus about the best treatment option, especially for cases of moderate or severe chronic slippage (Southwick classification). Some authors recommend treatment with fixation in situ, in the belief that remodeling of the residual deformity of the femoral neck during growth allows proper function of the hip joint. Others recommend correction at the site of the deformity (subcapital realignment), aiming for the anatomical reduction of the epiphysis and seeking to reduce the risk of chondral degeneration. The authors of this Technical Note present an alternative to the classical techniques of subcapital realignment for the treatment of moderate and severe chronic and stable SCFE, which allows adequate access to the hip joint and anatomical reduction of the slippage, besides having the theoretical advantage of rapid rehabilitation of the patient.

SUBMITTER: Dutra Roos B

PROVIDER: S-EPMC5495636 | biostudies-literature | 2017 Jun

REPOSITORIES: biostudies-literature

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Arthroscopic Subcapital Realignment in Chronic and Stable Slipped Capital Femoral Epiphysis.

Dutra Roos Bruno B Camargo de Assis Marcelo M Roos Milton Valdomiro MV Camisa Júnior Antero A Ungaretti Lima Ezequiel Moreno EM

Arthroscopy techniques 20170529 3

Stable slipped capital femoral epiphysis (SCFE) is the most common disease in the adolescent hip, with an estimated frequency of 10.8 in every 100,000 individuals. Recent studies of the biomechanics of femoroacetabular impingement indicate that small anatomical deformities of the hip arising from SCFE can potentially cause permanent acetabular chondral damage. There is no consensus about the best treatment option, especially for cases of moderate or severe chronic slippage (Southwick classificat ...[more]

PMID: 28706815

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Project description:Slipped Capital Femoral Epiphysis (SCFE) is a skeletal pathology affecting adolescents which requires timely surgery to prevent progression. Delays in diagnosis and treatment of SCFE can negatively affect patient prognosis, and few studies have examined how health disparities and barriers to care may influence these delays. In particular, only a handful of studies have included a Hispanic patient sample, despite this ethnic group's increased risk for the disease and unique barriers to care. A retrospective chart review was conducted for 124 patients surgically treated for idiopathic SCFE from January 2010 to September 2017. Patient data included age, facility and date of diagnosis, sex, BMI, race and ethnicity, Southwick slip angle, and insurance type. Results indicated that patients with private insurance were more likely to present with a mild slip than patients who were insured by Medicaid or uninsured, while patients without insurance were more likely to have severe slips. Patients without insurance also had a significantly higher mean slip than patients with insurance. The relationship between insurance status and slip angle degree was significant independent of race, even though Hispanic individuals were significantly more likely to have Medicaid or be uninsured. All patients without insurance, and a majority of those with Medicaid, were diagnosed in the emergency department. Time to diagnosis and slip angle were positively correlated, which suggests that longer delays led to increase of the slip angle, consistent with previous findings. Time to diagnosis and BMI were also correlated, which may be tied to socioeconomic factors, but the possibility of weight bias should not be dismissed. These results suggest that socioeconomic status and other factors may have contributed to barriers to care which led to delays in diagnosis and thus more severe slips. Future SCFE research should include health disparities variables to better inform treatment and prognosis.

Dataset Information

Arthroscopic Subcapital Realignment in Chronic and Stable Slipped Capital Femoral Epiphysis.

Publications

Arthroscopic Subcapital Realignment in Chronic and Stable Slipped Capital Femoral Epiphysis.

Similar Datasets

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