Page 119 - Slipped Capital Femoral Epiphysis Pathogenetic and Clinical aspects

Compared to the preoperative examination, the range of motion was significantly improved 1 year after the operation and also at the last clinical examination (Table 2). The HHS had an ‘excellent’ median score of 93 (range 49–100), with 17 (71%) patients scoring excellent/good and seven (29%) scoring fair/poor. The outcomes of the SF-36 were not significantly different from the those of the Dutch general population match for age [21] (Table 3).
The Kellgren–Lawrence score in our group was ≤1 in 80% on the anteroposterior X-ray and ≤1 in 100% on the false profile X-ray. Chondrolysis and AVN were not observed.
The preoperative lateral head shaft angle was not correlated with the outcome variables HHS, SF-36 and the Kellgren–Lawrence score. These outcome variables were also not correlated by the length of the follow-up.
Whereas normal values for BMI are between 19 and 25 kg/m2 [24], in our group the BMI was 26.1 (range 18.7–39.1) kg/m2 preoperatively and 28.5 (range 16.3–47.5) kg/ m2 at the last follow-up. More than half of the patients were and continued to be overweight.
Table 2.
Outcomes of the clinical examination (n = 28)
Flexion (°) Adduction (°)
Abduction (°) Internal rotation (°) External rotation (°)
97 (40–140) 113 20 (0–40) 26
33 (10–66) 39 -12 (-45–45) 24 53 (20–80) 50
(90–140)* 108 (10–50)* 25
(20–60) 41 (0–40)* 25 (30–75) 46
(70–125)*
(10–40)* 7 (25–55)*
(-15–50)*
(10–70)
Slipped Capital Femoral Epiphysis
Range of motion
Time point
Pre-operative
1-year Last post-operative follow-up
All values are given as the mean, with the range given in parenthesis * p < 0.05 compared to pre-operative status
Discussion
We have evaluated the long-term results following the treatment of moderate and severe SCFE with an epiphysiodesis and an ITO in one session. By performing the osteotomy, we were able to downgrade the severe and moderate slips into moderate and mild slips and even, if possible, into an anatomical position to improve the position of the head relative to the acetabulum.
117