Key result
Postoperative posterior epiphyseal tilt significantly correlated with the alpha angle (effect size 0.28, p=0.017), with a slip angle cut-off of 16.8° predicting later FAI type cam occurrence.
Why the study?
Given the high incidence of femoro-acetabular impingement type cam after slipped capital femoral epiphysis, the study analyzed whether a cam deformity is predictable following treatment.
Is a femoro-acetabular impingement type cam predictable after slipped capital femoral epiphysis treatment?
Observational (n=113)
Is a femoro-acetabular impingement type cam predictable after slipped capital femoral epiphysis treatment?
Effect estimate: effect size 0.28
p-value: p=0.017
The postoperative posterior epiphyseal tilt is a predictive factor for determining the alpha angle and predicting FAI type cam after SCFE treatment.
Post-SCFE cam common yet unpredictable by slip angle; leaves open need for universal monitoring and refined prediction models.
(1) Background: Previous studies have proven a high incidence of a femoro-acetabular impingement (FAI) type cam in patients sustaining a slipped capital femoral epiphysis (SCFE). Thus, the current study analyzed, if a cam deformity is predictable after SCFE treatment; (2) Methods: 113 cases of SCFE were treated between 1 January 2005 and 31 December 2017. The radiological assessment included the slip angle after surgery (referenced to the femoral neck (epiphyseal tilt) and shaft axis as Southwick angle) and the last available lateral center edge angle (LCEA), the acetabular- and alpha angle. A correlation was performed between these parameters and the last alpha angle to predict a FAI type cam; (3) Results: After a mean follow-up of 4.3 years (±1.9; 2.0–11.2), 48.5% of the patients showed a FAI type cam and 43.2% a dysplasia on the affected side. The correlation between the epiphyseal tilt and alpha angle was statically significant (p = 0.017) with a medium effect size of 0.28; (4) Conclusions: The postoperative posterior epiphyseal tilt was predictive factor to determine the alpha angle. However, the cut-off value of the slip angle was 16.8° for a later occurrence of a FAI type cam indicating a small range of acceptable deviations from the anatomical position for SCFE reconstruction.
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Wirries et al. (2021) conducted an observational in Slipped capital femoral epiphysis (SCFE) (n=113). Postoperative posterior epiphyseal tilt was evaluated on Correlation between epiphyseal tilt and alpha angle to predict FAI type cam (effect size 0.28, p=0.017). Postoperative posterior epiphyseal tilt significantly correlated with the alpha angle (effect size 0.28, p=0.017), with a slip angle cut-off of 16.8° predicting later FAI type cam occurrence.
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