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J Pediatr Orthop B 2019 Feb 13. Epub 2019 Feb 13.

Department of Orthopedic Surgery and Division of Surgery, KK Women's and Children's Hospital, Singapore.

To investigate whether the timing of surgery and surgical technique affect the rate of osteonecrosis in unstable slipped capital femoral epiphysis (SCFE). This is a retrospective review of all unstable slips that were treated at our institution over 8.5 years with a minimum follow-up period of 12 months. Read More

Gait Posture 2019 Jan 29;69:156-161. Epub 2019 Jan 29.

Cliniques universitaires Saint-Luc, Service d'orthopédie et de traumatologie de l'appareil locomoteur, Avenue Hippocrate 10, B-1200 Brussels, Belgium; Université catholique de Louvain, Secteur des Sciences de la Santé, Institut de Recherche Expérimentale et Clinique,Neuro Musculo Skeletal Lab (NMSK), Avenue Mounier 53, B-1200 Brussels, Belgium.

Background: Slipped capital femoral epiphysis (SCFE) is a common disorder in adolescent for which no consensus exists regarding management. The aim of the present study was to analyze gait modifications following SCFE treated with in situ fixation (ISF) and to relate it to radiologic stage.

Research Question: To verify if gait biomechanics are impaired in patients with SCFE and to try to determine a degree of slippage from which gait modifications would appear. Read More

J Bone Joint Surg Am 2019 Feb;101(3):209-217

Department of Orthopedic Surgery, Boston Children's Hospital, Boston, Massachusetts.

Background: Femoral morphology may influence the etiology of slipped capital femoral epiphysis (SCFE). We investigated whether radiographic parameters of femoral head-neck morphology are associated with a subsequent contralateral slip in patients presenting with unilateral SCFE.

Methods: We evaluated 318 patients treated for unilateral SCFE between 2000 and 2017. Read More

J Pediatr Orthop 2019 Mar;39(3):119-124

Division of Pediatric Orthopaedics, Department of Orthopaedics, Rainbow Babies and Children's Hospitals at Case Western Reserve University, Cleveland, OH.

Background: Factors including obesity and morphologic parameters around the hip that increase physeal stress are associated with an increased risk of slipped capital femoral epiphysis (SCFE). Recent evidence suggests that superior epiphyseal extension may confer stability to the physis and help protect against SCFE. The purpose of this study is to investigate the relationship between epiphyseal extension and SCFE using an age-matched and sex-matched cohort study. Read More

J Pediatr Orthop B 2019 Jan 29. Epub 2019 Jan 29.

Orthopaedic Institute for Children.

There is limited information regarding the outcome of in-situ fixation of unstable slipped capital femoral epiphysis (U-SCFE). We aimed to report the outcome of a cohort of patients with U-SCFE that were treated with in-situ fixation, by comparing it to the outcome of patients with stable slipped capital femoral epiphysis (S-SCFE).After Institutional Review Board approval, a retrospective analysis of patients with SCFE that were treated with in-situ fixation at a single institution between 2005 and 2016 was performed. Read More

Cureus 2018 Nov 15;10(11):e3598. Epub 2018 Nov 15.

Orthopedic Surgery, King Faisal Specialist Hospital and Research Centre, Riyadh, SAU.

Valgus slipped capital femoral epiphysis (SCFE) is very infrequent, and it is characterized by a superolateral displacement of the epiphysis on the metaphysis. To date, less than 100 cases of valgus SCFE have been described in the literature. Bilaterality of valgus SCFE is extremely rare, and it presents management challenges to the treating orthopedic surgeons. Read More

Medicine (Baltimore) 2019 Jan;98(3):e13997

Department of Orthopedic Surgery, The First Hospital of Jilin University, Changchun, Jilin, China.

Rationale: Slipped capital femoral epiphysis (SCFE) is a common hip problem in adolescents, usually individuals between 8 and 15 years old. Because of the frequent finding of growth abnormalities in affected children, various endocrine disturbances have been reported as the cause of the disease. However, there are few case reports of older patients in previous literature. Read More

J Pediatr Orthop 2019 Jan 14. Epub 2019 Jan 14.

Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Background: Slipped capital femoral epiphysis (SCFEs) can be idiopathic or atypical (associated with renal failure, radiation therapy, and endocrine disorders). It is important to estimate the likelihood that atypical SCFE shows different clinical and radiographic characteristics and complications with typical SCFEs.

Methods: We retrospectively reviewed 53 patients (66 hips) with SCFEs managed between 1995 and 2016. Read More

Gynecol Endocrinol 2019 Jan 7:1-5. Epub 2019 Jan 7.

a Department of Endocrinology , The Second Affiliated Hospital of Harbin Medical University , Harbin , PR China.

17α-Hydroxylase/17,20-lyase deficiency (17-OHD) is a rare disease caused by mutations of the CYP17A1 gene. Slipped capital femoral epiphysis (SCFE) rarely occurs in adults. There are occasional reports of adrenal myelolipoma (AML) in 17-OHD. Read More

J Child Orthop 2018 Dec;12(6):599-605

Department of Orthopaedics and Traumatology, Baltalimani Bone and Joint Diseases Education and Research Hospital, Istanbul, Turkey.

Purpose: The aim of our explorative study was to compare the differences in the coronal alignments of the hip, knee and ankle on the slip side and non-slip sides in patients with slipped capital femoral epiphysis (SCFE).

Methods: The study group consisted of 28 patients. On the full-length standing radiographs, measurements of articulo-trochanteric distance (ATD), neck-shaft angle (NSA), femoral offset, hip-knee-ankle axis, femur-tibial angle, mechanical axis deviation ratio (MAD-r), anatomical medial proximal femoral angle (aMPFA), mechanical lateral proximal femoral angle (mLPFA), anatomical lateral distal femoral angle (aLDFA), mechanical lateral distal femoral angle (mLDFA), knee joint line congruency angle, mechanical medial proximal tibial angle (mMPTA), mechanical lateral distal tibial angle (mLDTA), ankle joint line orientation angle (AJOA), and leg length discrepancy (LLD) were performed. Read More

J Orthop Sci 2018 Dec 13. Epub 2018 Dec 13.

Department of Orthopaedic Surgery, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.

Background: Joint-preserving procedures should be considered as much as possible for hip disorders in pediatric and young patients. However, in patients with extensive osteonecrosis (ON) of the femoral head combined with severe collapse and advanced secondary osteoarthritis (OA), the optimal procedure has not been elucidated. This retrospective study aimed to investigate the postoperative outcomes of 11 patients who underwent transtrochanteric rotational osteotomy (TRO) alone or with a combination treatment for various hip disorders in young patients and to evaluate the usefulness of TRO. Read More

Clin Orthop Relat Res 2018 Dec 13. Epub 2018 Dec 13.

T. D. Lerch, F. Schmaranzer, S. D. Steppacher, M. Tannast, K. A. Siebenrock, Department of Orthopaedic Surgery, Inselspital, University of Bern, Bern, Switzerland E. N. Novais, Department of Pediatric Orthopedic surgery, Boston Children's Hospital, Boston, MA, USA K. Ziebarth, Department of Pediatric Surgery, Inselspital, University of Bern, Bern, Switzerland.

Background: Prophylactic pinning of the asymptomatic and normal-appearing contralateral hip in patients with unilateral slipped capital femoral epiphysis (SCFE) remains controversial. Understanding the minimal 10-year clinical, functional, and radiographic outcomes of the contralateral asymptomatic hip in unilateral SCFE may be helpful in the decision regarding whether the benefits associated with potentially preventing a SCFE are outweighed by the risk of additional surgery.

Questions/purposes: Among patients with SCFE treated with prophylactic pinning of the asymptomatic and contralateral hip, we sought (1) to determine the complications and reoperations; (2) to evaluate the development of cam deformities and the frequency and severity of osteoarthritis progression; and (3) to characterize hip pain and function as measured by the Harris hip score (HHS) and the Hip Disability and Osteoarthritis Outcome Score (HOOS) at minimal 10-year followup. Read More

Surgeon 2019 02 2;17(1):61. Epub 2018 Dec 2.

Faculty of Medicine, University of Berne, Berne, Switzerland.

Hip Int 2018 Nov 20:1120700018811313. Epub 2018 Nov 20.

Department of Trauma and Orthopaedics, Sheffield Children's Hospital, Sheffield, UK.

Background:: Management of avascular necrosis (AVN) of the femoral head in slipped capital femoral epiphysis (SCFE) is difficult. We proposed to ascertain if staged hip distraction could prevent collapse and recover the femoral head.

Methods:: A retrospective review of the hip database retrieved 16 children with unstable SCFE and AVN. Read More

J Pediatr 2018 Nov 16. Epub 2018 Nov 16.

Department of Orthopaedic Surgery, Children's Mercy Hospital, Kansas City, MO.

Objective: To prospectively characterize pain locations in slipped capital femoral epiphysis (SCFE) and evaluate pain locations as predictors of a delay in diagnosis.

Study Design: This was an institutional review board approved prospective study of 110 children who underwent surgery for SCFE at a tertiary children's hospital between 2009 and 2015. Standardized pain diagrams were completed by 107 children. Read More

Br J Neurosurg 2018 Nov 19:1-4. Epub 2018 Nov 19.

a Department of Neurosurgery , NHS Tayside , Dundee , United Kingdom.

An 18-year-old man who underwent bilateral pinning of his hip joints after a left unstable Slipped Capital Femoral Epiphysis (right pinned prophylactically) was noted to have delayed secondary sexual characteristics and post-operative diabetes insipidus. The patient also described a history of fatigue, headache and polydipsia for the past 4 years. Endocrine investigations revealed reduced androgen levels, hypocortisolism, a borderline normal Serum ACE and secondary hypothyroidism. Read More

Am J Sports Med 2018 Dec 12;46(14):3446-3453. Epub 2018 Nov 12.

American Hip Institute, Westmont, Illinois, USA.

Background:: Hip arthroscopy for the treatment of instability in the setting of borderline dysplasia is controversial. Capsular management in such cases is an important consideration, and plication has been described as a reliable technique, with good midterm outcomes reported when indications are appropriate.

Hypothesis:: Patients with borderline dysplasia who have a lower lateral center-edge angle (LCEA) and greater age will be at a higher risk of failure after arthroscopic capsular plication. Read More

Bone Joint J 2018 Nov;100-B(11):1524-1532

Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil; Department of Biomechanics, Medicine and Rehabilitation of the Locomotor System, Clinical Hospital of Ribeirão Preto, Ribeirão Preto, Brazil.

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. Read More

J Pediatr Orthop 2018 Oct 29. Epub 2018 Oct 29.

Children's Orthopaedics of Atlanta, Atlanta, GA.

Background: Increased intracapsular hip pressure is thought to be one of the possible etiologies of femoral head avascular necrosis after intra-articular proximal femoral fractures or acute slipped capital femoral epiphysis. The purpose of this study was to evaluate the relationship between intra-articular hip pressure (IAP) and epiphyseal perfusion pressure (EPP), and its dependency on skeletal maturity using a porcine model.

Methods: Seven female Yorkshire-hybrid pigs were used to study the direct relationship between IAP and EPP. Read More

Pediatrics 2018 Nov 22;142(5). Epub 2018 Oct 22.

Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, United Kingdom.

: media-1vid110.1542/5828355774001PEDS-VA_2018-1067 BACKGROUND: Slipped capital femoral epiphysis (SCFE) is believed to be associated with childhood obesity, although the strength of the association is unknown.

Methods: We performed a cohort study using routine data from health screening examinations at primary school entry (5-6 years old) in Scotland, linked to a nationwide hospital admissions database. Read More

J Med Imaging Radiat Oncol 2018 Oct;62 Suppl 1:137-138

Department of Radiology, Concord Repatriation General Hospital, Concord, New South Wales, Australia.

J Child Orthop 2018 Oct;12(5):454-460

Department of Orthopedic Surgery, Nationwide Children's Hospital, Columbus, Ohio, USA.

Purpose: Early diagnosis and treatment of slipped capital femoral epiphysis (SCFE) is important to prevent slip progression and avoid complications. We sought to determine if MRI findings in patients with unilateral SCFE could indicate 'pre-slip' or predict future SCFE in the contralateral hip.

Methods: A prospective study evaluated patients with unilateral SCFE over a two-year period. Read More

J Child Orthop 2018 Oct;12(5):444-453

Department of Orthopedic Surgery, Boston Children's Hospital, Boston, USA.

Purpose: To investigate changes in acetabular morphology during the follow-up of slipped capital femoral epiphysis (SCFE) and search for factors associated with acetabular dysplasia at skeletal maturity.

Methods: We evaluated 108 patients with unilateral SCFE (mean age at slip, 12.3 years sd 1. Read More

J Child Orthop 2018 Oct;12(5):434-443

Department of Orthopaedics, Skane University Hospital, Lund, Sweden.

Purpose: To evaluate outcomes three years after treatment for slipped capital femoral epiphysis (SCFE): development of avascular necrosis (AVN), subsequent surgery, hip function and the contralateral hip.

Methods: This prospective cohort study included a total national population of 379 children treated for SCFE between 2007 and 2013. A total of 449 hips treated for SCFE and 151 hips treated with a prophylactic fixation were identified. Read More

J Child Orthop 2018 Oct;12(5):428-433

Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA.

Purpose: Slipped capital femoral epiphysis (SCFE) is an adolescent hip condition with a high risk of complication. The purpose of this study was to evaluate trends in treatment using a prospectively collected paediatric nationally representative database.

Methods: A total of 9034 patients undergoing treatment for idiopathic SCFE were selected by querying the Healthcare Cost and Utilization Project's Kids' Inpatient Database for the years 1997, 2000, 2003, 2006, 2009 and 2012. Read More

Hawaii J Med Public Health 2018 Sep;77(9):215-219

University of Utah, Salt Lake City, UT; Shriners Hospitals for Children - Salt Lake City, Salt Lake City, UT (GTF).

The Maori of New Zealand have been identified as a high-risk population for slipped capital femoral epiphysis (SCFE). This study assessed whether the burden of disease from SCFE in the American Territory of American Samoa is similar to that identified in the Maori. This was a retrospective review of children from American Samoa treated for SCFE at a tertiary care pediatric hospital between 2005-2014. Read More

Pediatr Ann 2018 Sep;47(9):e377-e380

Slipped capital femoral epiphysis (SCFE) is one of the most common hip pathologies that occurs during adolescence, and its incidence has been increasing over the past decades. For this reason, pediatricians should be aware of this entity to ensure an early diagnosis and intervene in a timely manner. The typical patient with SCFE is an adolescent who is obese presenting with hip pain, but it can also occur in children who are not obese; therefore, SCFE should be part of the differential diagnosis in any skeletally immature patient presenting with hip or knee pain. Read More

J Pediatr Orthop 2019 Mar;39(3):e165-e167

Division of Orthopaedic Surgery.

Background: Slipped capital femoral epiphysis (SCFE) is a well-characterized disorder of the hip seen in adolescent patients. It is characterized by deformity secondary to failure through the proximal femoral growth plate, which results in posterior-inferior displacement of the epiphysis on the proximal femoral metaphysis. Long-term sequelae of SCFE may include osteonecrosis, residual deformity, leg length discrepancy, degenerative joint disease, and chronic pain. Read More

Pediatr Rev 2018 Sep;39(9):454-463

Montefiore Medical Center and the Children's Hospital at Montefiore, Bronx, NY.

Int Orthop 2018 Aug 22. Epub 2018 Aug 22.

Centre for Hip Preservation, Sheffield Children's Hospital NHS Foundation Trust and Doncaster Royal Infirmary, Sheffield, S102RA, UK.

Aim: We intend to compare the outcomes of arthroscopic osteoplasty with open neck osteotomy for correction of the hip impingement and improvement of hip function in children with moderate to severe healed Slipped Capital Femoral Epiphysis (SCFE). Our aim is to verify if arthroscopic osteoplasty could achieve the same outcome as open procedures.

Patients And Methods: A retrospective analysis of the hospital hip database retrieved 187 cases of SCFE from 2006 to 2013. Read More

JBJS Case Connect 2018 Jul-Sep;8(3):e60

Department of Radiology (A.D.), Pediatric Emergency Service (F.E. and V.S.), and Pediatric Orthopaedic Service (C.S., R.D., and D.C.), University Hospital of Geneva, Geneva, Switzerland.

Case: We report the case of an 11-year-old girl who developed osteonecrosis of the femoral head in the radiographically normal, asymptomatic left hip that had been fixed prophylactically in the context of a slipped capital femoral epiphysis (SCFE) that had been detected on the contralateral hip. The etiology of the osteonecrosis remains unknown.

Conclusion: This case report demonstrates that prophylactic fixation of a radiographically normal, asymptomatic hip in the context of an SCFE on the contralateral side has the potential for substantial complications. Read More

Orthop J Sports Med 2018 Jun 25;6(6):2325967118781579. Epub 2018 Jun 25.

Department of Orthopedic Surgery, Boston Children's Hospital, Boston, Massachusetts, USA.

Background: Understanding the development of the capital femoral epiphysis is essential to identify pathologic variations that may lead to cam morphology.

Purpose/hypothesis: The purpose of this study was to investigate the development of the capital femoral epiphysis during childhood and adolescence, with specific morphologic analysis of the peripheral growth and the metaphyseal surface of the growth plate. We hypothesized that age- and sex-dependent morphologic variations of the peripheral growth (cupping) and surface anatomy (epiphyseal tubercle) of the epiphysis would be evident with increasing age. Read More

Orthop Rev (Pavia) 2018 Jun 4;10(2):7542. Epub 2018 Jul 4.

Guilan University of Medical Sciences, Rasht.

Total hip arthroplasty is one of the best treatments for restoring function and activity in young patients with advanced joint diseases. One-Stage Bilateral Total Hip Arthroplasty (BTHA) offers many advantages, which are important to younger patients and diminished costs and time in comparison with sequential THA. There is currently much concern about the safety of this procedure. Read More

Int Orthop 2018 Jul 23. Epub 2018 Jul 23.

Second Department Orthopaedics, "P. and A. Kyriakou" Children's Hospital, Athens, Greece.

Purpose: To compare longitudinal growth and cam deformity of the proximal femur after treatment for slipped capital femoral epiphysis (SCFE) with one screw versus two smooth pins.

Methods: We studied 43 patients (29 males, 14 females; mean age, 12.1 years; range, 9. Read More

Pediatr Clin North Am 2018 08;65(4):801-826

Research Institute, Child Health Evaluative Sciences, Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada.

Chronic musculoskeletal pain (CMP) is one of the main reasons for referral to a pediatric rheumatologist and is the third most common cause of chronic pain in children and adolescents. Causes of CMP include amplified musculoskeletal pain, benign limb pain of childhood, hypermobility, overuse syndromes, and back pain. CMP can negatively affect physical, social, academic, and psychological function so it is essential that clinicians know how to diagnose and treat these conditions. Read More

J Pediatr Orthop 2018 Jul 2. Epub 2018 Jul 2.

Children's of Alabama, Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, AL.

Background: Large national databases have been increasingly used in recent years to determine the rate of adverse events and identify factors associated with altered surgical outcomes. This can be especially useful to evaluate rare events such as 30-day mortality. Despite differences between national pediatric databases, there have been no comparison studies in the pediatric orthopaedic population. Read More

Surgeon 2019 02 25;17(1):58-60. Epub 2018 Jun 25.

Warwick Medical School, Gibbet Hill Campus, University of Warwick, Coventry, UK.

J Child Orthop 2018 Jun;12(3):232-235

Shriners Hospitals for Children Honolulu, Honolulu, Hawaii, USA.

Purpose: Previous work has examined the impact of delay of diagnosis in slipped capital femoral epiphysis (SCFE) but not the impact of delay in treatment after radiographic diagnosis. Due to requirements for long distance transportation from less developed regions for many of our patients, our hospital was able to study variation in time between diagnosis and surgery for SCFE, as related to slip severity.

Methods: This is a retrospective review of patients treated for SCFE between 2005 and 2014 at a tertiary care paediatric hospital. Read More

J Pediatr Orthop 2018 Aug;38(7):e371-e376

Department of Orthopedic Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA.

Background: A rotational mechanism of slipped capital femoral epiphysis (SCFE) in which the epiphyseal tubercle acts as a fulcrum has been recently described. However, there is limited radiographic evidence supporting this theory. We aimed to investigate whether a radiographic lucency around the epiphyseal tubercle (peritubercle lucency sign) could be observed before or at the diagnosis of a subsequent slip in patients initially presenting with unilateral SCFE. Read More

J Pediatr Orthop B 2018 Nov;27(6):491-495

Departments of Orthopedic Surgery, School of Medicine.

Intracapsular cuneiform osteotomy was initially introduced to restore the morphology of the proximal femur after slipped capital femoral epiphysis (SCFE). However, whether this procedure results in a higher risk of avascular necrosis (AVN) or lower incidence of cam deformity than in-situ pinning is unclear. The aim of this study was to compare the outcomes of intracapsular cuneiform osteotomy and in-situ pinning to treat SCFE in children. Read More

J Pediatr Orthop 2018 Jul;38 Suppl 1:S5-S12

Texas Scottish Rite Hospital for Children, Department of Orthopaedics, University of Texas at Southwestern Medical Center, Dallas, TX.

The treatment of slipped capital femoral epiphysis (SCFE) in North America has seen a change over the past 15 to 20 years due to a better understanding of the blood flow supplying the femoral head, the ability to monitor the pressure/flow in real time and greater access to the deformity with the development of surgical approaches providing that access. These advances have mainly affected the treatment of the unstable SCFE to mitigate the risk of avascular necrosis but have also been utilized for the stable SCFE when severe deformity remains. This paper will provide a summary of some of the current techniques utilized in North America in the treatment of SCFE and will focus on the studies reported on this condition from this continent. Read More

J Pediatr Orthop 2018 Jul;38 Suppl 1:S1-S4

Department of Paediatric Orthopaedics, Royal London Hospital, Barts Health NHS Trust, Whitechapel Road, Whitechapel, London, UK.

Treatment of slipped capital femoral epiphysis remains a contentious and debated issue. The opinion for the correct method of treatment can differ not only between different continents and nations, but also between units and surgeons within individual units. We aim to review the European perspective on the treatment of slipped capital femoral epiphysis and consider the trends for treatment among the European orthopaedic surgical community. Read More

Int Orthop 2018 May 24. Epub 2018 May 24.

Department of Orthopedic Surgery, Children's Hospital Colorado, Aurora, CO, USA.

Purpose: The aim of this study was to compare clinical outcomes and radiographic correction after modified Dunn procedure versus inadvertent closed reduction and percutaneous pinning for the treatment of unstable slipped capital femoral epiphysis (SCFE).

Methods: We evaluated 45 patients with unstable SCFE treated using the modified Dunn procedure (n = 27) or percutaneous pinning (n = 18) during a minimum follow-up of one year. Clinical outcomes were assessed using the Heyman and Herndon scores. Read More

J Pediatr Orthop B 2018 Nov;27(6):496-502

Department of Paediatric Orthopaedics, IWK Health Centre.

Physeal closure after slipped capital femoral epiphysis fixation can be difficult to assess on two-dimensional conventional radiographs. Radiostereometric analysis offers improved motion detection over conventional radiography, whereas the EOS biplanar imager provides a means for low radiation weight-bearing images. This phantom study assessed the reliability of measuring motion using radiostereometric analysis in the EOS using a slipped capital femoral epiphysis model. Read More

J Surg Orthop Adv Spring 2018;27(1):58-63

Department of Orthopaedics, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania.

Alternative medicine in pediatrics is expanding, with chiropractic now a common choice for families seeking alternative medical care. Currently, there is sparse information in the literature exploring the role of chiropractic in orthopaedic pathology. The objective of this case series is to present pediatric patients who received treatment from chiropractors and orthopaedic physicians as well as to review the respective existing research. Read More

J Child Orthop 2018 Apr;12(2):160-166

Division of Paediatric Orthopaedics, Children's Hospital at Montefiore Medical Center, Bronx, New York, New York, USA.

Purpose: To evaluate sensitivity, specificity and accuracy of a radiographic slipped capital femoral epiphysis (SCFE)-diagnosis among medical specialists.

Methods: Three paediatricians, three paediatric radiologists and three paediatric orthopaedic surgeons completed two rounds of a survey of anteroposterior and frog-leg lateral radiographs of patients with a diagnosis of SCFE (25), femoroacetabular impingement (four), Legg-Calvé-Perthes (11) or no hip pathology (ten). Intra- and interobserver agreement among specialties regarding the diagnosis of a SCFE were assessed using Cohen's kappa coefficient (κ). Read More

J Child Orthop 2018 Apr;12(2):152-159

Department of Radiology, Boston Children's Hospital, Boston, Massachusetts, USA.

Purpose: To determine age-and gender-dependent variation of epiphyseal tilt and epiphyseal angle using CT in adolescents without hip pathology.

Methods: Pelvic CT scans were obtained in 132 adolescents for evaluation of abdominal pain. Radially oriented planes around the femoral neck were reformatted and the epiphyseal tilt and angle were measured in the anterior, anterosuperior and superior planes. Read More

Bone Joint J 2018 05;100-B(5):680-684

University of Oxford, Botnar Research Centre, Oxford, UK.

Aims: High-quality clinical research in children's orthopaedic surgery has lagged behind other surgical subspecialties. This study used a consensus-based approach to identify research priorities for clinical trials in children's orthopaedics.

Methods: A modified Delphi technique was used, which involved an initial scoping survey, a two-round Delphi process and an expert panel formed of members of the British Society of Children's Orthopaedic Surgery. Read More

J Arthroplasty 2018 07 21;33(7S):S253-S258. Epub 2018 Feb 21.

Palo Alto Medical Foundation Research Institute, Palo Alto, CA; Department of Medicine, The University of California, Los Angeles School of Medicine, Los Angeles, CA 90095.

Background: To identify the incidence, contributing factors, and outcomes of perioperative greater trochanter fractures associated with the direct anterior approach.

Methods: This is a retrospective analyses of 1401 primary THAs. Age, side, height, weight, body mass index, preoperative ambulatory status, discharge status, and hospital length of stay were identified. Read More

J Pediatr Orthop 2018 Jul;38(6):e300-e304

Division of Orthopaedic Surgery, Children's Hospital of Philadelphia, Philadelphia, PA.

Background: Developmental dysplasia of the hip (DDH), which encompasses a wide spectrum of disease from mild dysplasia to frank dislocation, is one of the most common developmental deformities of the lower extremities and one of the leading causes of future osteoarthritis and hip arthroplasty. Legg-Calvé-Perthes disease (LCPD) results from a vascular insult to the growing femoral epiphysis, which in turn can create permanent morphologic changes to the hip joint. Slipped capital femoral epiphysis (SCFE) occurs when the proximal femoral physis fails allowing the epiphysis to displace in relation to the metaphysis. Read More