What question did this study set out to answer?

To assess the clinical and radiological outcomes of subcapital osteotomy of the femoral neck for treating symptomatic femoroacetabular impingement secondary to a healed slipped capital femoral epiphysis.

November 1, 2014The Bone & Joint Journal

Subcapital osteotomy of the femoral neck for patients with healed slipped capital femoral epiphysis

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Why the study?

Does subcapital osteotomy of the femoral neck improve clinical and radiological outcomes in patients with symptomatic FAI resulting from a healed SCFE?

Population

8 patients with symptomatic femoroacetabular impingement after a moderate to severe healed slipped capital…

Design

Case_series

Follow-up

mean 41 months (20 to 84)

Authors

KBKamal BaliMcMaster University PRPam RailtonUniversity of Calgary GKGerhard KieferIntermountain Healthcare

Discussion

Member takes

Implication

May support subcapital osteotomy in symptomatic healed SCFE; hypothesis-generating and should not yet change practice.

Key Points

To assess the clinical and radiological outcomes of subcapital osteotomy of the femoral neck for treating symptomatic femoroacetabular impingement secondary to a healed slipped capital femoral epiphysis.
Evaluated N=8 patients (8 hips; mean age 17.8 years, range 13 to 29; 6 males, 2 females) with moderate-to-severe healed slips undergoing subcapital intracapsular osteotomy via surgical hip dislocation with an extended retinacular soft-tissue flap.
Followed patients for a mean of 41 months (range 20 to 84), measuring Harris Hip Score (HHS), WOMAC scores, and radiographic slip angles and femoral neck offsets.
At final follow-up, the mean HHS was 92.5 (85 to 100), and mean WOMAC scores were 1.3 (0 to 4) for pain, 1.4 (0 to 6) for stiffness, and 3.6 (0 to 19) for function.
Radiographic angles showed significant correction (all p < 0.01): anterior slip angle improved from 36.6° to 10.3°, lateral slip angle from 36.6° to 15.4°, anterior offset angle decreased from 64.4° to 32.0°, and center head-trochanteric distance shifted from -8.2 mm to +2.8 mm.
Complications included nonunion requiring revision surgery in two patients, with no observed cases of avascular necrosis of the femoral head.

Structured PICO

Does subcapital osteotomy of the femoral neck improve clinical and radiological outcomes in patients with symptomatic FAI resulting from a healed SCFE?

Population

8 patients (8 hips) with symptomatic femoroacetabular impingement (FAI) after a moderate to severe healed slipped capital femoral epiphysis (SCFE), mean age 17.8 years, 6 males and 2 females.

Intervention

Subcapital intracapsular osteotomy of the femoral neck after surgical hip dislocation and creation of an extended retinacular soft-tissue flap.

Outcome

Clinical assessment (range of movement, Harris Hip Score, WOMAC) and radiological assessment (anterior slip angle, lateral slip angle, anterior offset angle, centre head-trochanteric distance)

Subcapital osteotomy of the femoral neck provides effective correction of deformity and relief of impingement symptoms in patients with healed SCFE.

Cite This Study

Bali et al. (2014) studied this question.

synapsesocial.com/papers/6a795cfb77336a1bae02451c https://doi.org/10.1302/0301-620x.96b11.33519

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Subcapital osteotomy of the femoral neck for patients with healed slipped capital femoral epiphysis

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Subcapital osteotomy of the femoral neck for patients with healed slipped capital femoral epiphysis

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider