Page 118 - Slipped Capital Femoral Epiphysis Pathogenetic and Clinical aspects

Chapter 7
The range of motion and body mass index (BMI) were determined during the clinical examination, and hip function was measured using the HHS [20]. The completed SF-36 questionnaire was used as a measure of the general health of the patients relative to the Dutch general population [21].
Osteoarthritis of the hip at follow-up was quantified from the X-rays using the Kellgren–Lawrence scale (0–4) [22, 23]. The presence of chondrolysis and avascular necrosis was also assessed from the X-rays. Of the six patients who were not able to come to the clinic, the most recent X-rays available were used instead.
Statistical analysis
Results were analyzed using SPSS ver. 12.0 software (SPSS, Chicago, IL). Due to skewed distributions, continuous data (HHS, SF36, range of motion) were described as medians and ranges. The outcomes were analyzed non-parametrically using Mann–Whitney U tests in for independent comparisons and Wilcoxon signed- rank tests for pre- and post-operative comparisons. Categorical variables were described as numbers and percentages and were compared using the chi-square test. A p value <0.05 was taken to be significant.
Results
Of the 28 patients, 24 responded to the questionnaires. Twenty-two patients were able to come to the clinic for re-assessment and radiographic evaluation. The median period of follow-up of all patients was 8.2 years (range 2.0–25.7).
Two early postoperative complications were seen. The first was a leaking wound without infection, and the second was a patient who developed calf thrombosis in the operated leg. Both complications were successfully treated. No long-term complications occurred.
All osteotomies healed uneventfully. Neither chondrolysis nor avascular necrosis were seen on the X-rays.
Of the 32 slips, 22 were classified moderate and ten as severe. From the 22 moderate slips, 21 were downgraded to a mild slip and one was still a moderate slip (from 52° to 35°). Of the ten severe slips, seven were downgraded to moderate slips and three were even downgraded to mild slips. The mean slip was significantly improved from 52° (range: 30–74°) to 22° (range 0–56°) (P < 0.01).
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