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Combined Pinning and Arthroscopic Osteoplasty for Stable Slipped Capital Femoral Epiphysis

  • Benjamin F. Ricciardi
  • Hannes M. Manner
  • Michael LeunigEmail author
Chapter

Abstract

In the past, the natural history of mild slipped capital femoral epiphysis (SCFE) was thought to be benign, and in situ pinning was considered the standard of care. Recently, open and arthroscopic studies have found high rates of intra-articular damage to the acetabular cartilage and labrum even in mild SCFE. Additionally, more recent clinical studies have found hip pain in one-third of patients with a mild SCFE and reduced Tegner and Lysholm scores at intermediate follow-up relative to age-matched controls. Femoroacetabular impingement (FAI), caused by the anterior metaphyseal prominence of the femoral neck entering the acetabulum, appears to be a source of this intra-articular injury. It is believed that by removing the prominent metaphyseal bone and reestablishing an appropriate head-neck offset, femoral osteoplasty will eliminate impingement and reduce subsequent intra-articular damage. Based on the increasing evidence of early articular damage after mild SCFE, the senior author (ML) began treating all mild slips with in situ pinning and immediate arthroscopic head-neck osteoplasty in 2008.

Keywords

Slipped capital femoral epiphysis Hip arthroscopy Percutaneous pinning Stable SCFE Osteoplasty 

Suggested Reading

  1. Dodds MK, McCormack D, Mulhall KJ. Femoroacetabular impingement after slipped capital femoral epiphysis: does slip severity predict clinical symptoms? J Pediatr Orthop. 2009;29(6):535–9.CrossRefGoogle Scholar
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  3. Leunig M, Horowitz K, Manner H, Ganz R. In situ pinning with arthroscopic osteoplasty for mild SCFE: a preliminary technical report. Clin Orthop Relat Res. 2010;468(12):3160–7.CrossRefGoogle Scholar
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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Benjamin F. Ricciardi
    • 1
  • Hannes M. Manner
    • 3
  • Michael Leunig
    • 2
    Email author
  1. 1.Orthopedic SurgeryUniversity of Rochester Medical CenterRochesterUSA
  2. 2.Department of Pediatric OrthopedicsSchulthess ClinicZurichSwitzerland
  3. 3.Department of Orthopedic SurgerySchulthess ClinicZurichSwitzerland

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