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
OA post SCFE AVN post SCFE
Incidence of THA after SCFE
- 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%