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Good long-term outcome of the untreated contralateral hip in unilateral slipped capital femoral epiphysis: Forty hips with a mean follow-up of 41 years

PURPOSE: There is no consensus regarding prophylactic fixation of the contralateral hip in slipped capital femoral epiphysis (SCFE). In order to further study this question, we evaluated the long-term natural history of untreated contralateral hips. METHODS: Forty patients treated for unilateral SCF...

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Autores principales: Wensaas, Anders, Gunderson, Ragnhild B., Svenningsen, Svein, Terjesen, Terje
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4391051/
https://www.ncbi.nlm.nih.gov/pubmed/25270941
http://dx.doi.org/10.1007/s11832-014-0611-2
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author Wensaas, Anders
Gunderson, Ragnhild B.
Svenningsen, Svein
Terjesen, Terje
author_facet Wensaas, Anders
Gunderson, Ragnhild B.
Svenningsen, Svein
Terjesen, Terje
author_sort Wensaas, Anders
collection PubMed
description PURPOSE: There is no consensus regarding prophylactic fixation of the contralateral hip in slipped capital femoral epiphysis (SCFE). In order to further study this question, we evaluated the long-term natural history of untreated contralateral hips. METHODS: Forty patients treated for unilateral SCFE without evidence of subsequent contralateral slip during adolescence were reviewed with a mean follow-up of 36 years (range 21–50 years). The deformity after SCFE may demonstrate radiographic signs of cam-type femoroacetabular impingement. We, therefore, measured α-angles in the contralateral hips on anteroposterior (AP) and frog-leg lateral radiographs. The angles were compared with those of a control group of adults without SCFE. Five years after the radiographic examination, with a mean follow-up of 41 years, all patients were evaluated by telephone interview. As range of motion and deformity could not be examined, a modified Harris hip score (HHS) (maximum score of 91 points) was used. A modified HHS <76 points and/or radiographic osteoarthritis (OA) was classified as a poor long-term outcome. RESULTS: The mean value of the AP α-angle was significantly higher in the contralateral hips in SCFE patients than in the control group (55° vs. 46°), while the mean value of the lateral α-angle was not. Abnormally high values for one or both α-angles were found in 16 contralateral hips (40 %), of which five patients had abnormal values for both α-angles and were considered to have had an asymptomatic contralateral slip. Five patients (13 %) had a poor outcome in the contralateral hip, of which three patients (8 %) had OA. There was a significant association between hips with both α-angles that were abnormal and poor outcome. CONCLUSIONS: Since the natural history showed good long-term radiographic and clinical outcome in 35 of 40 patients and only three had OA, we conclude that routine prophylactic fixation of the contralateral hip is not indicated.
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spelling pubmed-43910512015-04-09 Good long-term outcome of the untreated contralateral hip in unilateral slipped capital femoral epiphysis: Forty hips with a mean follow-up of 41 years Wensaas, Anders Gunderson, Ragnhild B. Svenningsen, Svein Terjesen, Terje J Child Orthop Original Clinical Article PURPOSE: There is no consensus regarding prophylactic fixation of the contralateral hip in slipped capital femoral epiphysis (SCFE). In order to further study this question, we evaluated the long-term natural history of untreated contralateral hips. METHODS: Forty patients treated for unilateral SCFE without evidence of subsequent contralateral slip during adolescence were reviewed with a mean follow-up of 36 years (range 21–50 years). The deformity after SCFE may demonstrate radiographic signs of cam-type femoroacetabular impingement. We, therefore, measured α-angles in the contralateral hips on anteroposterior (AP) and frog-leg lateral radiographs. The angles were compared with those of a control group of adults without SCFE. Five years after the radiographic examination, with a mean follow-up of 41 years, all patients were evaluated by telephone interview. As range of motion and deformity could not be examined, a modified Harris hip score (HHS) (maximum score of 91 points) was used. A modified HHS <76 points and/or radiographic osteoarthritis (OA) was classified as a poor long-term outcome. RESULTS: The mean value of the AP α-angle was significantly higher in the contralateral hips in SCFE patients than in the control group (55° vs. 46°), while the mean value of the lateral α-angle was not. Abnormally high values for one or both α-angles were found in 16 contralateral hips (40 %), of which five patients had abnormal values for both α-angles and were considered to have had an asymptomatic contralateral slip. Five patients (13 %) had a poor outcome in the contralateral hip, of which three patients (8 %) had OA. There was a significant association between hips with both α-angles that were abnormal and poor outcome. CONCLUSIONS: Since the natural history showed good long-term radiographic and clinical outcome in 35 of 40 patients and only three had OA, we conclude that routine prophylactic fixation of the contralateral hip is not indicated. Springer Berlin Heidelberg 2014-09-30 2014-10 /pmc/articles/PMC4391051/ /pubmed/25270941 http://dx.doi.org/10.1007/s11832-014-0611-2 Text en © The Author(s) 2014 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.
spellingShingle Original Clinical Article
Wensaas, Anders
Gunderson, Ragnhild B.
Svenningsen, Svein
Terjesen, Terje
Good long-term outcome of the untreated contralateral hip in unilateral slipped capital femoral epiphysis: Forty hips with a mean follow-up of 41 years
title Good long-term outcome of the untreated contralateral hip in unilateral slipped capital femoral epiphysis: Forty hips with a mean follow-up of 41 years
title_full Good long-term outcome of the untreated contralateral hip in unilateral slipped capital femoral epiphysis: Forty hips with a mean follow-up of 41 years
title_fullStr Good long-term outcome of the untreated contralateral hip in unilateral slipped capital femoral epiphysis: Forty hips with a mean follow-up of 41 years
title_full_unstemmed Good long-term outcome of the untreated contralateral hip in unilateral slipped capital femoral epiphysis: Forty hips with a mean follow-up of 41 years
title_short Good long-term outcome of the untreated contralateral hip in unilateral slipped capital femoral epiphysis: Forty hips with a mean follow-up of 41 years
title_sort good long-term outcome of the untreated contralateral hip in unilateral slipped capital femoral epiphysis: forty hips with a mean follow-up of 41 years
topic Original Clinical Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4391051/
https://www.ncbi.nlm.nih.gov/pubmed/25270941
http://dx.doi.org/10.1007/s11832-014-0611-2
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