TITLE

Chondrolysis, Osteonecrosis, and Slip Severity in Patients with Subsequent Contralateral Slipped Capital Femoral Epiphysis

AUTHOR(S)
Yildirim, Yakup; Bautista, Severino; Davidson, Richard S.
PUB. DATE
March 2008
SOURCE
Journal of Bone & Joint Surgery, American Volume;Mar2008, Vol. 90-A Issue 3, p485
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Prophylactic pinning of the radiographically and clinically normal contralateral hip in a patient with a unilateral slipped capital femoral epiphysis remains controversial. The purpose of this study was to identify the prevalence of chondrolysis and osteonecrosis and the degree of slip severity in contra- lateral hips with a subsequent slipped capital femoral epiphysis to determine whether the outcome or complications on the contralateral side were greater than the risks of prophylactic pinning. Methods: The medical records of the patients operated on between 1993 and 2003 at a single hospital for treatment of a slipped capital femoral epiphysis were retrospectively evaluated. The severity and the chronicity of the slips were graded. Only children who initially had had a unilateral slip and had been followed for a minimum of twenty-four months or until skeletal maturity were included in the analysis for detection of a subsequent contralateral slip. Patients with more than twelve months of follow-up were included in the analysis for detection of osteonecrosis and chondrolysis. Results: Two hundred and twenty-seven patients had a unilateral slipped capital femoral epiphysis at the time of the primary admission. A subsequent slip developed in the contralateral hip of eighty-two children (36%) within a mean of 6.5 months. Eighteen of the contralateral slips were of moderate or severe severity, with a potential for a poor outcome due to a risk of osteoarthritis in the future. Osteonecrosis or chondrolysis, each an established complication with a poor long-term prognosis, developed in five of the patients with a subsequent contralateral slip.
ACCESSION #
31375446

 

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