Cam deformity and hip degeneration are common after fixation of a slipped capital femoral epiphysis

Figures & data

Figure 1. A. CAM-type deformity with characteristic loss of sphericity of the femoral head and decreased head/neck offset laterally and anteriorly after SCFE with in situ screw fixation. B. SCFE with loss of sphericity of the femoral head and decreased head/neck offset laterally and anteriorly and in situ screw fixation. C. Radial reconstruction of a MRI 3T scan showing anterior CAM-type deformity with the characteristic loss of sphericity of the femoral head and decreased head/neck offset anteriorly at 15 years after SCFE with in situ screw fixation.

Figure 2. Flow diagram for obtainment of measures of labral degeneration and chondrolabral damage in affected hips.

Table 1. ROM for affected and unaffected hips

Variable	Affected hips Median	Affected hips IQR	Unaffected hips Median	Unaffected hips IQR	p-value
Extension	20° (15–25)	15–25°	21° (17.5–25)	20–25°	0.5
Flexion	110° (100–115)	99–116°	110° (105–115)	106–115°	0.7
Internal rotation	15° (5–25)	5–25°	15° (15–35)	15–31°	0.2
External rotation	40° (35–45)	34–45°	45° (35–47.5)	36–45°	0.3

Table 2. Association between the variables

A	B	C	D	E	F	G	H	I	J	K	L	M
1	F	13	Left	88/38	–/–	–/–	35	19	80/98	80	3/10	+/–
2	F	^a	Right	^a/^a	^a/^a	^a/^a	42	21	100/97	100	3/37	–/–
3	F	12	Left	70/59	+/–	–/–	35	23	83/96	83	^a/^a	+/–
4	F	11	Right	^a/^a	^a/^a	^a/^a	40	21.1	100/100	100	1/35	–/–
5	F	^a	Both	96/79	+/–	–/–	41	20	100/100	100	^a/^a	–/–
6	M	13	Left	95/110	+/+	+/–	36	22	83/93	83	15/11	+/+
7	F	14	Both	59/84	–/+	+/–	27	26	100/100	100	30/13	–/–
8	F	11	Both	62/72	+/+	–/–	41	21	100/100	100	^a/^a	–/–
9	M	18	Right	50/^a	–/^a	–/^a	27	25	100/100	100	3/13	–/–
10	F	10	Right	63/^a	+/^a	–/^a	41	20	90/97	90	1/25	–/–
11	F	11	Both	54/55	+/+	–/–	38	22	88/100	88	^a/^a	+/–
12	M	14	Both	83/^a	+/+	–/^a	^a	^a	99/99	99	16/35	–/–
13	M	12	Left	56/51	–/+	–/–	23	22	100/100	100	^a/^a	–/–
14	M	13	Both	103/90	+/+	–/–	^a	^a	86/84	86	4/34	+/+
15	M	11	Both	107/^a	+/^a	+/^a	40	21	92/91	92	32/3	–/–
16	F	12	Right	51/95	+/+	–/–	28	23	100/100	100	12/27	–/–
17	M	13	Left	88/^a	–/^a	–/–	39	21	73/100	73	18/15	–/–

^a not possible to evaluated or score.

A Patient no.

B Sex

C Age at operation

D Sick hip

E Alpha angle (Left/Right)

F Labral degeneration (Left/Right)

G Chondrolabral damage (Left/Right)

H SF-36 PCS

I SF-36 MCS

J WOMAC

K Osteoarthritis (Left/Right)

L Preoperative Southwick angle (Left/Right)

M Impingement test (Left/Right)

Table 3. SCFE follow-up studies evaluating CAM deformity, osteoarthritis, and patient-reported outcome

A	B	C	D	E	F	G	H
Zilkens et al.	12 (7–17)	11 (4–20)	47	30 of 38	35 of 38 ^b	SF-36 PF 86.7	HHS 92,
				^a		SF-37 RP 78.9	range 60–100
Fraitzl et al.	14 (12–17)	14 (11–21)	16	13 of 16	^c	^c	^c
				^a	^c
Miese et al.	13 (9–15)	12 (4–39)	35	29 of 35	19 of 175 ^d	^c	^c
				^a	44 of 175 ^d
Wensaas et al. 2012		37 (21–50)	43	^c	10 of 43	^c	HHS 92,
				^a			range 53–100
Wensaas et al. 2011	13 (11–15)	38 (21–57)	76	^c	23 of 76	EQ-5D Index 0.84	HHS 88,
				^a		EQ-5D Visual 74	range 45–100
The current study	12 (10–14)	15 (10–17)	24	15 of 24	1 of 24	SF-36 PCS 54	Median WOMAC 100,
				14 of 17	11 of 14	SF-36 MCS 56	range 73–100

^a No MRI performed.

^b No differentiation between osteoarthritis and pre-osteoarthritis.

^c Not evaluated.

^d Measured at 5 places in each hip

A Study

B Age at surgery (range)

C Mean follow-up (range), year

D No. SCFE hips

E No. of patients with Cam deformity after SCFE radiography / MRI

F No. of patients with osteoarthritis/pre-osteoarthritis

GPatient-reported outcome (HRQoL) after SCFE

HPatient-reported joint function outcome after SCFE, HHS Harris Hip Score

Wensaas A, Gunderson RB, Svenningsen S, Terjesen T. Femoroacetabular impingement after slipped upper femoral epiphysis: the radiological diagnosis and clinical outcome at long-term follow-up. J Bone Joint Surg (Br)(internet) 2012; 94 (11): 1487–93.

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Wensaas A, Svenningsen S, Terjesen T. Long-term outcome of slipped capital femoral epiphysis: a 38-year follow-up of 66 patients. J Child Orthop 2011; 5 (2): 75–82.

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