SCFE

 

SCFE OA

 

Indications for THA

 

Osteoarthritis

- abnormal morphology

- loss of head neck offset

- bony impingement on acetabulum

 

AVN

 

Larson et al J Pediatric Orthop 2010

- 38 THA for SCFE out of 33,000

- 25 for AVN, 13 for OA

- AVN THR at average 20y, compared to OA at 38y

 

SCFE OASCFE AVN

OA post SCFE                                         AVN post SCFE

 

Incidence of THA after SCFE

 

Carney et al JBJS Am 1991

- 155 hips with 40 year follow up

- 24% THA

 

Wensaas et al J Child Orthop 2011

- 76 hips with 38 year follow up

- 21% THA

 

Issues with THA

 

Young age

Previous metalwork

Abnormal head neck morphology / reduced offset

Abnormal femur from previous osteotomy

 

Results THA

 

Thillemann et al Acta Orthop 2008

- Danish Joint Registry

- 10 year revision rate for SCFE 9.3%

- 10 year revision rate all cases 8.7%