Arthroscopic subcapital realignment osteotomy in chronic and stable slipped capital femoral epiphysis: early results

Abstract

ABSTRACT OBJECTIVE: This study aimed to evaluate the clinical and radiographic outcomes, as well as the complications of arthroscopic subcapital realignment osteotomy in chronic and stable slipped capital femoral epiphysis (SCFE). As indicated by the literature review, this is the first time this type of arthroscopic osteotomy was described. METHODS: Between June 2012 and December 2014, seven patients were submitted to arthroscopic subcapital realignment osteotomy in chronic and stable SCFE. The mean age was 11 years and 4 months, and the mean follow-up period was 16.5 months (6-36). Clinical results were evaluated using the Modified Harris Hip Score (MHHS), which was measured pre- and postoperatively. Radiographs were evaluated using the Southwick quantitative classification and the epiphysis-diaphysis angle (pre- and postoperatively). Complications were assessed. RESULTS: The mean preoperative MHHS was 35.8 points, and 97.5 points post-operatively (p < 0.05). Radiographically, five patients were classified as Southwick classification grade II and two as grade III. The mean correction of the epiphysis-diaphysis angle was 40°. No immediate postoperatively complications were observed. One patient presented femoral head avascular necrosis, without collapse or chondrolysis at the most recent follow-up (22 months). CONCLUSION: The arthroscopic technique presented for subcapital realignment osteotomy in chronic and stable SCFE showed satisfactory clinical and radiographic outcomes in a 16.5 months follow-up period.

Keywords

• Epiphyses, slipped
• Hip
• Femur head
• Arthroscopy
• Child