Eleven Year Results of Total Hip Arthroplasty in Patients with Secondary Osteoarthritis Due to Slipped Capital Femoral Epiphysis
Benjamin Schoof 1, Mustafa Citak*, 1, Padhraig F O’Loughlin 2, Daniel Kendoff 1, Carl Haasper 1, Thorsten Gehrke 1, Matthias Gebauer 1
1 Helios ENDO-Klinik Hamburg, Department of Orthopaedic Surgery, Hamburg, Germany
2 Cappahgh National Orthopaedic Hospital, Department of Orthopaedic Surgery, Finglas Dublin, Ireland
Total hip arthroplasty (THA) in patients with a history of Slipped Capital Femoral Epiphysis (SCFE), is typically indicated to address the consequent deformity of the proximal femur and/or acetabulum. It can be a challenging procedure for the orthopaedic surgeon. Previous studies have focused on prevention of osteoarthritis post-SCFE. However, there is a paucity of data on the outcomes of total hip arthroplasty in patients with osteoarthritis secondary to SCFE. This study was performed to assess the mid-term results of total hip arthroplasty in this patient cohort.
Materials and Methods:
All patients with secondary osteoarthritis due to slipped capital femoral epiphysis, treated with total hip arthroplasty between 1987 and 2005, were included in this retrospective study (n=30). Thirty patients (17 male, 13 female) met the inclusion criteria with one patient lost to follow-up and one unrelated death one year before follow up examination, thereby leaving 28 patients (32 hips) eligible for the study with a mean follow-up time period of 11.2 years. The Harris Hip Score (HHS) and MOS 36 short form health survey (SF36) were determined preoperatively and at most recent follow-up for all patients. Complications were also noted for all cases.
The mean Harris Hip Score increased significantly from 47 (32-59; SD=8.3) to 92.3 (65-100; SD=8.2) (p<0.0001). The SF-36 health survey showed an improvement of quality-of-life in all sub-scales. Overall, revision surgery was required in six cases (19 %). Aseptic loosening, leading to implant removal, was noted in five cases. A single-stage revision to address infection was performed in one case. The cumulative survival rate at latest follow-up was 81 %. No other complications were encountered during the study.
Despite a higher failure rate, compared to total hip arthroplasty in the treatment of primary osteoarthritis, total hip arthroplasty can be considered a feasible option for patients with secondary osteoarthritis of the hip due to slipped capital femoral epiphysis. The current study demonstrates good outcomes in patients treated with a cementless column-preserving prosthesis, which is of particular relevance for this young patient cohort. However, further clinical prospective randomized studies are warranted to provide more definitive evidence.
Keywords: Total hip arthroplasty, slipped capital femoral epiphysis.
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* Address correspondence to this author at the Department of Orthopaedic Surgery, Helios ENDO Klinik Hamburg, Holstenstraße 2, D-22767 Hamburg, Germany; Tel: +49 40 3197 0; Fax: +49 40 3197 0;