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Slipped capital femoral epiphysis management and the arthroscope

Accadbled, Franck and May, Olivier and Thévenin-Lemoine, Camille and Sales de Gauzy, Jérôme Slipped capital femoral epiphysis management and the arthroscope. (2017) Journal of Children's Orthopaedics, 11 (2). 128-130. ISSN 1863-2521

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Official URL: https://doi.org/10.1302/1863-2548-11-160281


BACKGROUND: In situ pinning of slipped capital femoral epiphysis (SCFE) results in various degrees of deformity of the femoral head-neck junction. Repetitive trauma from cam-type femoroacetabular impingement (FAI) can lead to labral tears and injury to the articular cartilage causing loss of function. Arthroscopic osteoplasty is an alternative to open procedure and to Southwick/Imhäuser-type osteotomies in symptomatic selected cases. SURGICAL TECHNIQUE: The amount of bone to be resected has to be carefully planned pre-operatively. Only gentle traction is applied on a well-padded perineal support. A spherical burr is used to gradually resect the prominence. Intra-operative fluoroscopy is very useful when checking adequate reshaping of the head-neck junction is obtained. RESULTS: Arthroscopy often reveals acetabular cartilage lesions, labrum hyperhemia and fraying which rarely require repair. Arthroscopic osteoplasty provides satisfactory pain relief and, to a lesser extent, restores hip internal rotation. CONCLUSION: Arthroscopic osteoplasty is more technically and time-demanding in post SCFE than idiopathic FAI. It requires strong arthroscopic skills and experience in hip arthroscopy. It stands as a reasonable alternative to open procedure or flexion osteotomies in symptomatic FAI post mild to moderate SCFE. It provides pain relief and to a lesser extent restores internal rotation of the hip.

Item Type:Article
HAL Id:hal-02135739
Audience (journal):International peer-reviewed journal
Uncontrolled Keywords:
Institution:Other partners > Clinique Médipôle Garonne (FRANCE)
Other partners > Centre Hospitalier Universitaire de Toulouse - CHU Toulouse (FRANCE)
Deposited On:21 Mar 2019 13:17

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