Natural History of Untreated Chronic Slipped Capital Femoral Epiphysis

From 1915 to 1952, 31 hips in 28 patients with slipped capital femoral epiphysis were observed without interventional treatment at the University of Iowa Department of Orthopaedic Surgery. A slip was considered chronic if the symptoms had been present for 3 weeks or more. The severity of the slip was determined by radiographs. Assessment included Iowa Hip Rating and grading of radiographic degenerative changes. The mean duration of patient followup from the onset of symptoms was 41 years. The mean patient age was 54 years old at review, and 13 years old at onset of symptoms. Degenerative arthritis developed in hips with displaced slipped capital femoral epiphysis. Untreated slipped capital femoral epiphysis can progress to a severe degree. The natural history of chronic slipped capital femoral epiphysis is favorable provided that displacement is minimal and remains so.