Hip arthroscopy following slipped capital femoral epiphysis fixation: chondral damage and labral tears findings

Author:

Besomi Javier123,Escobar Valeria2,Alvarez Santiago2,Valderrama Juanjose4,Lopez Jaime3,Mella Claudio3,Lara Joaquin5,Meneses Claudio12

Affiliation:

1. Pediatric Orthopaedic Surgery Unit, Orthopaedic Surgery Department and Urgencia Escolar Clinica Alemana de Santiago/Facultad de Medicina Clinica Alemana – Universidad del Desarrollo, Santiago, Chile

2. Pediatric Orthopaedic Surgery Service Hospital Clinico San Borja Arriaran, Santiago, Chile

3. Hip and Pelvis Unit, Orthopaedic Surgery Department Clinica Alemana de Santiago – Chile / Facultad de Medicina Clinica Alemana – Universidad del Desarrollo, Santiago, Chile

4. Knee Surgery Unit, Department of Orthopaedic Surgery Hospital Clinico Mutual de Seguridad and Department of Orthopaedic Surgery Clinica Indisa, Santiago, Chile

5. Hip Center Clinica Las Condes, Santiago, Chile

Abstract

Purpose This study investigated the association between chondrolabral damage and time to arthroscopic surgery for slipped capital femoral epiphysis (SCFE). Methods This was a descriptive retrospective study that enrolled patients with SCFE who underwent hip arthroscopy for femoral osteochondroplasty after SCFE fixation. SCFE type, time from SCFE symptom onset or slip fixation surgery to hip arthroscopy and intraarticular arthroscopic findings were recorded. Acetabular chondrolabral damage was evaluated according to the Konan and Outerbridge classification systems. Nested analysis of variance and the chi-squared test were used for statistical analyses. Results We analyzed 22 cases of SCFE in 17 patients (five bilateral). The mean age at the time of hip arthroscopy was 13.6 years-old (8–20), and mean time from SCFE fixation to arthroscopy was 25.1 months (3 weeks to 8 years). Labral frying was present in 20 cases, labral tears in 16 and acetabular chondral damage in 17. The most frequent lesion was type 3 (41%) (Konan classification). Two cases had a grade III and 1 had a grade II acetabular chondral lesion (Outerbridge classification). Positive associations were observed between time from SCFE to hip arthroscopy and hip intraarticular lesions evaluated using Konan (p = 0.004) and Outerbridge (p = 0.000) classification systems. There was no association between SCFE severity (chi-squared = 0.315), stability (chi-squared = 0.558) or temporality (chi-squared = 0.145) type and hip intraarticular lesions. Conclusion A longer time from SCFE symptom onset and fixation to hip arthroscopy is associated with greater acetabular chondrolabral damage. Level of evidence IV

Publisher

SAGE Publications

Subject

Orthopedics and Sports Medicine,Pediatrics, Perinatology and Child Health

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