Slipped Capital Femoral Epiphysis is a leading cause of femoroacetabular impingement and early onset hip osteoarthritis. A review

Abstract

Slipped Capital Femoral Epiphysis is the leading cause of limp in the adolescent population. Obesity and endocrine disorders are major predisposing factors that very often lead to bilateral hip involvement. Not infrequently, a delayed or a missed diagnosis results in progression of the slip towards stages of higher severity, implying less favorable long term results after treatment. In situ stabilization of the slipped physis is the globally preferred treatment, yet it does not prevent the affected hip to develop early onset hip osteoarthritis compared to the general population. Femoroacetabular impingement due to a deformed femoral neck seems to be the intermediate pathologic process that causes labral and acetabular cartilage damage and inevitably leads to early hip arthrosis. In fact the vast majority of the slips, especially the moderate and severe slips, will present signs of femoroacetabular impingement. The severity of the slip correlates with the magnitude of the labral and acetabular cartilage lesions. In moderate and severe slips, residual growth and remodelling after in situ stabilization are unable to compensate for the remaining femoral neck deformity. In these slips, an arthroscopic femoral neck osteochondroplasty or a modified Dunn procedure might be more effective in order to reduce the risk of early onset hip osteoarthritis.