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Comparison between modified Dunn procedure and in situ fixation for severe stable slipped capital femoral epiphysis: A retrospective study of 29 hips followed for 2–7 years

BACKGROUND AND PURPOSE: The best treatment option for severe slipped capital femoral epiphysis (SCFE) is still controversial. We compared clinical and radiographic outcomes of modified Dunn procedure (D) and in situ fixation (S) in severe SCFE. PATIENTS AND METHODS: We retrospectively compared D and...

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Autores principales: Trisolino, Giovanni, Stilli, Stefano, Gallone, Giovanni, Santos Leite, Pedro, Pignatti, Giovanni
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Taylor & Francis 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5901520/
https://www.ncbi.nlm.nih.gov/pubmed/29451057
http://dx.doi.org/10.1080/17453674.2018.1439238
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author Trisolino, Giovanni
Stilli, Stefano
Gallone, Giovanni
Santos Leite, Pedro
Pignatti, Giovanni
author_facet Trisolino, Giovanni
Stilli, Stefano
Gallone, Giovanni
Santos Leite, Pedro
Pignatti, Giovanni
author_sort Trisolino, Giovanni
collection PubMed
description BACKGROUND AND PURPOSE: The best treatment option for severe slipped capital femoral epiphysis (SCFE) is still controversial. We compared clinical and radiographic outcomes of modified Dunn procedure (D) and in situ fixation (S) in severe SCFE. PATIENTS AND METHODS: We retrospectively compared D and S, used for severe stable SCFE (posterior sloping angle (PSA) > 50°) in 29 patients (15 D; 14 S). Propensity analysis and inverse probability of treatment weights (IPTW) to adjust for baseline differences were performed. Patients were followed for 2–7 years. RESULTS: Avascular necrosis (AVN) occurred in 3 patients out of 15, after D, causing conversion to total hip replacement (THR) in 2 cases. In S, 1 hip developed chondrolysis, requiring THR 3 years after surgery. 3 symptomatic femoroacetabular impingements (FAI) occurred after S, requiring corrective osteotomy in 1 hip, and osteochondroplasty in another case. The risk of early re-operation was similar between the groups. The slippage was corrected more accurately and reliably by D. The Nonarthritic Hip Score was similar between groups, after adjusting for preoperative and postoperative variables. INTERPRETATION: Although D was superior to S in restoring the proximal femoral anatomy, without increasing the risk of early re-operation, some concern remains regarding the potential risk of AVN in group D.
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spelling pubmed-59015202018-04-23 Comparison between modified Dunn procedure and in situ fixation for severe stable slipped capital femoral epiphysis: A retrospective study of 29 hips followed for 2–7 years Trisolino, Giovanni Stilli, Stefano Gallone, Giovanni Santos Leite, Pedro Pignatti, Giovanni Acta Orthop Slipped Capital Femoral Epiphysis BACKGROUND AND PURPOSE: The best treatment option for severe slipped capital femoral epiphysis (SCFE) is still controversial. We compared clinical and radiographic outcomes of modified Dunn procedure (D) and in situ fixation (S) in severe SCFE. PATIENTS AND METHODS: We retrospectively compared D and S, used for severe stable SCFE (posterior sloping angle (PSA) > 50°) in 29 patients (15 D; 14 S). Propensity analysis and inverse probability of treatment weights (IPTW) to adjust for baseline differences were performed. Patients were followed for 2–7 years. RESULTS: Avascular necrosis (AVN) occurred in 3 patients out of 15, after D, causing conversion to total hip replacement (THR) in 2 cases. In S, 1 hip developed chondrolysis, requiring THR 3 years after surgery. 3 symptomatic femoroacetabular impingements (FAI) occurred after S, requiring corrective osteotomy in 1 hip, and osteochondroplasty in another case. The risk of early re-operation was similar between the groups. The slippage was corrected more accurately and reliably by D. The Nonarthritic Hip Score was similar between groups, after adjusting for preoperative and postoperative variables. INTERPRETATION: Although D was superior to S in restoring the proximal femoral anatomy, without increasing the risk of early re-operation, some concern remains regarding the potential risk of AVN in group D. Taylor & Francis 2018-04 2018-02-16 /pmc/articles/PMC5901520/ /pubmed/29451057 http://dx.doi.org/10.1080/17453674.2018.1439238 Text en © 2018 The Author(s). Published by Taylor & Francis on behalf of the Nordic Orthopedic Federation. https://creativecommons.org/licenses/by-nc/3.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution-Non-Commercial License (https://creativecommons.org/licenses/by-nc/3.0)
spellingShingle Slipped Capital Femoral Epiphysis
Trisolino, Giovanni
Stilli, Stefano
Gallone, Giovanni
Santos Leite, Pedro
Pignatti, Giovanni
Comparison between modified Dunn procedure and in situ fixation for severe stable slipped capital femoral epiphysis: A retrospective study of 29 hips followed for 2–7 years
title Comparison between modified Dunn procedure and in situ fixation for severe stable slipped capital femoral epiphysis: A retrospective study of 29 hips followed for 2–7 years
title_full Comparison between modified Dunn procedure and in situ fixation for severe stable slipped capital femoral epiphysis: A retrospective study of 29 hips followed for 2–7 years
title_fullStr Comparison between modified Dunn procedure and in situ fixation for severe stable slipped capital femoral epiphysis: A retrospective study of 29 hips followed for 2–7 years
title_full_unstemmed Comparison between modified Dunn procedure and in situ fixation for severe stable slipped capital femoral epiphysis: A retrospective study of 29 hips followed for 2–7 years
title_short Comparison between modified Dunn procedure and in situ fixation for severe stable slipped capital femoral epiphysis: A retrospective study of 29 hips followed for 2–7 years
title_sort comparison between modified dunn procedure and in situ fixation for severe stable slipped capital femoral epiphysis: a retrospective study of 29 hips followed for 2–7 years
topic Slipped Capital Femoral Epiphysis
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5901520/
https://www.ncbi.nlm.nih.gov/pubmed/29451057
http://dx.doi.org/10.1080/17453674.2018.1439238
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