The results of osteotomy at the base of femoral neck with osteoplasty in restoration of abductor function and strength in slipped capital femoral epiphysis

Author(s)

Angelico, A. C. C. ^[1] ; Garcia, L. M. ^[1] ; Icuma, T. R. ^[2] ; Herrero, C. F. ^[1] ; Maranho, D. A. ^{[3, 4]}

Affiliation

^[1] Univ Sao Paulo, Ribeirao Preto Med Sch, Orthopaed Surg, Ribeirao Preto - Brazil

^[2] Univ Sao Paulo, Med Sch, Dept Social Med, Ribeirao Preto - Brazil

^[3] Univ Sao Paulo, Ribeirao Preto Med Sch, Paediat Orthopaed Surg, Ribeirao Preto - Brazil

^[4] Clin Hosp Ribeirao Preto, Dept Biomech Med & Rehabil Locomotor Syst, Ribeirao Preto - Brazil

• Document type: Journal article
• Source: BONE & JOINT JOURNAL; v. 100B, n. 11, p. 1524-1532, NOV 2018.
• Web of Science Citations: 1

Abstract

Aims The aims of this study were to evaluate the abductor function in moderate and severe slipped capital femoral epiphysis (SCFE), comparing the results of a corrective osteotomy at the base of the femoral neck and osteoplasty with 1) in situ epiphysiodesis for mild SCFE, 2) contralateral unaffected hips, and 3) hips from healthy individuals. Patients and Methods A total of 24 patients (mean age 14.9 years (sd 1.6); 17 male and seven female patients) with moderate or severe SCFE (28 hips) underwent base of neck osteotomy and osteoplasty between 2012 and 2015. In situ epiphysiodesis was performed in seven contralateral hips with mild slip. A control cohort was composed of 15 healthy individuals (mean age 16.5 years (sd 2.5); six male and nine female patients). The abductor function was assessed using isokinetic dynamometry and range of abduction, with a minimum one-year follow-up. Results We found no differences in mean peak abductor torque between the hips that underwent osteotomy and those that received in situ epiphysiodesis (p = 0.63), but the torque was inferior in comparison with contralateral hips without a slip (p < 0.01) and hips from control individuals (p < 0.001). The abduction strength was positively correlated with the range of hip abduction (R = 0.36; p < 0.001). Conclusion Although the abductor strength was not restored to normal levels, moderate and severe SCFE treated with osteotomy at the base of the femoral neck and osteoplasty showed abductor function similar to in situ epiphysiodesis in hips with less severe displacement. (AU)

• FAPESP's process: 16/04376-3 - Basicervical osteotomy combined to cervicoplasty for the treatment of slipped capital femoral epiphysis: comparison of results with capital realignment and in situ fixation techniques
• Grantee: Daniel Augusto Carvalho Maranho
• Support Opportunities: Scholarships abroad - Research