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Predicting subsequent contralateral slipped capital femoral epiphysis: an evidence-based approach

PURPOSE: The purpose of this study was to identify risk factors for developing a subsequent contralateral slipped capital femoral epiphysis (SCFE) and provide a prediction score to quantify risk of subsequent slip at the time of initial presentation. METHODS: This retrospective study included patien...

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Autores principales: Swarup, Ishaan, Shah, Ronit, Gohel, Shivani, Baldwin, Keith, Sankar, Wudbhav N.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The British Editorial Society of Bone & Joint Surgery 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7184641/
https://www.ncbi.nlm.nih.gov/pubmed/32351620
http://dx.doi.org/10.1302/1863-2548.14.200012
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author Swarup, Ishaan
Shah, Ronit
Gohel, Shivani
Baldwin, Keith
Sankar, Wudbhav N.
author_facet Swarup, Ishaan
Shah, Ronit
Gohel, Shivani
Baldwin, Keith
Sankar, Wudbhav N.
author_sort Swarup, Ishaan
collection PubMed
description PURPOSE: The purpose of this study was to identify risk factors for developing a subsequent contralateral slipped capital femoral epiphysis (SCFE) and provide a prediction score to quantify risk of subsequent slip at the time of initial presentation. METHODS: This retrospective study included patients that presented with a unilateral SCFE between 2006 and 2017. Chart and radiographic review were performed to collect demographic, clinical and radiographic risk factors. Descriptive statistics, univariate analyses and multivariate regression analysis were used to compare risk factors between patients that did or did not develop a subsequent contralateral SCFE. RESULTS: This study included 183 patients and 33 patients (18%) developed a subsequent contralateral SCFE. Younger age at time of initial presentation, lower modified Oxford Score and smaller difference in epiphyseal-diaphyseal angle between both sides during index presentation were significant predictors of subsequent contralateral SCFE. Specifically, age ≤ 11 years, modified Oxford Score ≤ 20 and difference in epiphyseal-diaphyseal angle of ≤ 21° between both hips were predictive of a contralateral slip (Area Under the Curve = 0.78; p < 0.05). The presence of each risk factor increased the risk of subsequent contralateral SCFE and having all three risk factors increased the risk to 73%. CONCLUSION: There is a significant risk of subsequent contralateral SCFE in patients with unilateral SCFE, and predictive risk factors include younger age, lower modified Oxford Score and smaller difference in epiphyseal-diaphyseal angle between the affected and unaffected hips. LEVEL OF EVIDENCE: Level III
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spelling pubmed-71846412020-04-29 Predicting subsequent contralateral slipped capital femoral epiphysis: an evidence-based approach Swarup, Ishaan Shah, Ronit Gohel, Shivani Baldwin, Keith Sankar, Wudbhav N. J Child Orthop Original Clinical Article PURPOSE: The purpose of this study was to identify risk factors for developing a subsequent contralateral slipped capital femoral epiphysis (SCFE) and provide a prediction score to quantify risk of subsequent slip at the time of initial presentation. METHODS: This retrospective study included patients that presented with a unilateral SCFE between 2006 and 2017. Chart and radiographic review were performed to collect demographic, clinical and radiographic risk factors. Descriptive statistics, univariate analyses and multivariate regression analysis were used to compare risk factors between patients that did or did not develop a subsequent contralateral SCFE. RESULTS: This study included 183 patients and 33 patients (18%) developed a subsequent contralateral SCFE. Younger age at time of initial presentation, lower modified Oxford Score and smaller difference in epiphyseal-diaphyseal angle between both sides during index presentation were significant predictors of subsequent contralateral SCFE. Specifically, age ≤ 11 years, modified Oxford Score ≤ 20 and difference in epiphyseal-diaphyseal angle of ≤ 21° between both hips were predictive of a contralateral slip (Area Under the Curve = 0.78; p < 0.05). The presence of each risk factor increased the risk of subsequent contralateral SCFE and having all three risk factors increased the risk to 73%. CONCLUSION: There is a significant risk of subsequent contralateral SCFE in patients with unilateral SCFE, and predictive risk factors include younger age, lower modified Oxford Score and smaller difference in epiphyseal-diaphyseal angle between the affected and unaffected hips. LEVEL OF EVIDENCE: Level III The British Editorial Society of Bone & Joint Surgery 2020-04-01 /pmc/articles/PMC7184641/ /pubmed/32351620 http://dx.doi.org/10.1302/1863-2548.14.200012 Text en Copyright © 2020, The author(s) http://creativecommons.org/licenses/by-nc/4.0/ Open Access This article is distributed under the terms of the Creative Commons Attribution-Non Commercial 4.0 International (CC BY-NC 4.0) licence (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed.
spellingShingle Original Clinical Article
Swarup, Ishaan
Shah, Ronit
Gohel, Shivani
Baldwin, Keith
Sankar, Wudbhav N.
Predicting subsequent contralateral slipped capital femoral epiphysis: an evidence-based approach
title Predicting subsequent contralateral slipped capital femoral epiphysis: an evidence-based approach
title_full Predicting subsequent contralateral slipped capital femoral epiphysis: an evidence-based approach
title_fullStr Predicting subsequent contralateral slipped capital femoral epiphysis: an evidence-based approach
title_full_unstemmed Predicting subsequent contralateral slipped capital femoral epiphysis: an evidence-based approach
title_short Predicting subsequent contralateral slipped capital femoral epiphysis: an evidence-based approach
title_sort predicting subsequent contralateral slipped capital femoral epiphysis: an evidence-based approach
topic Original Clinical Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7184641/
https://www.ncbi.nlm.nih.gov/pubmed/32351620
http://dx.doi.org/10.1302/1863-2548.14.200012
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