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Radiological outcome and gait function of SCFE patients after growth arrest

  • Original Clinical Article
  • Published:
Journal of Children's Orthopaedics

Abstract

Purpose

Slipped capital femoral epiphysis (SCFE) represents the most common disorder of the hip in adolescents and a preliminary stage of degenerative joint disease. Up to now, functional outcome evaluation measured by objective instruments has been commonly neglected. The present study investigates whether the pathoanatomy of the hip joint after SCFE—analyzed on a standard X-ray—match functional results gained by three-dimensional gait analysis. A variation of functional outcome depending on the radiological findings after growth arrest is hypothesized.

Methods

Thirty-seven SCFE patients after growth arrest [mean age 18.5 years, standard deviation (SD) 4.61] with unilateral affection were included. The pathoanatomy of the hip joint was classified according to the radiological index of Heyman and Herndon and to aspherity. Three-dimensional gait analysis parameters were evaluated and subgroup analysis was performed according to the radiological results.

Results

The radiological findings revealed very good results in general (average comprehensive index of Heyman and Herndon 94 ± 9 %, aspherity grade <2). Significant deviations of gait parameters in relation to the radiological result were an increase in step width, sagittal range of motion (ROM) of the pelvis and foot progression for the worse subgroup.

Conclusions

Taken as a whole, the pathoanatomy of the hip joint after SCFE matched the functional results gained by gait analysis. Functional outcome varied slightly depending on the radiological findings after growth arrest. Differences were most pronounced for foot progression. Only with the help of gait analysis was it possible to describe deviations more precisely and objectively. Further studies are required in order to show which alterations are relevant for the development of secondary osteoarthritis.

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Acknowledgments

We thank Mrs. I. Kamps for her assistance in performing the gait analysis and preparing the data for further analysis.

Conflict of interest

Each author certifies that he or she has no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article. The authors declare that they have no conflict of interest.

Ethical statement

The study has been approved by the local ethics committee for medical studies. Patients or their parents gave their written informed consent.

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Authors and Affiliations

  1. Department of Orthopaedics, Medical Faculty, University of Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany

    Bettina Westhoff, Katharina Schröder, Kristina Weimann-Stahlschmidt, Christoph Zilkens & Rüdiger Krauspe

  2. Department of Computational Statistics, University of Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany

    Reinhart Willers

Authors
  1. Bettina Westhoff
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  2. Katharina Schröder
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  3. Kristina Weimann-Stahlschmidt
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  4. Christoph Zilkens
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  5. Reinhart Willers
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  6. Rüdiger Krauspe
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Corresponding author

Correspondence to Bettina Westhoff.

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Westhoff, B., Schröder, K., Weimann-Stahlschmidt, K. et al. Radiological outcome and gait function of SCFE patients after growth arrest. J Child Orthop 7, 507–512 (2013). https://doi.org/10.1007/s11832-013-0528-1

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  • DOI: https://doi.org/10.1007/s11832-013-0528-1

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