Service d'orthopédie-traumatologie, Institut de l'appareil locomoteur, Hôpital Pierre-Paul-Riquet, cinquième étage, 308, avenue de Grande-Bretagne, 31059 Toulouse, France.
Orthop Traumatol Surg Res. 2013 Nov;99(7):791-7. doi: 10.1016/j.otsr.2013.07.014. Epub 2013 Sep 21.
The rate of osteoarthritis of the hip secondary to slipped capital femoral epiphysis (SCFE) is a subject of debate, and its frequency is underestimated in particular because of subclinical forms that may not be diagnosed during childhood.
The frequency of radiographic anomalies subsequent to SCFE in adults requiring hip arthroplasty is higher than that reported in recent studies (6% to 15%).
A prospective single-center epidemiological radiography study was performed by one observer. Hip X-rays of patients who were being treated by arthroplasty for advanced hip osteoarthritis between January 2010 and May 2012 were analyzed. The etiology of osteoarthritis was classified in each patient according to the data obtained (primary, SCFE, dysplasia, protrusio acetabuli, other). The lateral view head-neck index (LVHNI) was used to quantify posterior translation of the femoral head, and identify SCFE sequelae.
One hundred and eighty-six hips were included. Osteoarthritis was considered primary in 51 patients (27.4%), secondary to dysplasia in 42 (22.5%), protrusio acetabuli in 38 (20.5%) or another disease in nine (4.9%) while 46 hips (24.7%) presented a radiographic image suggesting SCFE past history. SCFE type deformities were the primary etiology of osteoarthritis in patients less than 60years old (30/84 or 35.7%). The mean age of patients in the SCFE group was 56.2years old (26-80) compared to 66 (54-91) for the primary osteoarthritis group (P<0.0001). The mean LVHNI was 13% (9-24%) in the SFCE group, the mean body mass index was 27.1kg/m(2) (±3.5; 18.2-35.4) in the SFCE group and the male to female ratio was 7.3/1.
Our study identified a population with a morphological SCFE type anomaly of the coxofemoral joint (LVHNI>9%), which results in the development of earlier osteoarthritis than that found in the rest of the population. SCFE is more common than reported in the literature because it is the first etiology of osteoarthritis of the hip in subjects less than 60years old.
Level III. Diagnostic prospective study with a control group.
髋关节滑脱节（SCFE）继发骨关节炎的发生率存在争议，尤其是因为可能在儿童时期未被诊断出的亚临床形式，其发生率被低估。
需要髋关节置换术的成年人中，继发于 SCFE 的放射学异常的频率高于最近研究报道的（6%至 15%）。
一名观察者进行了一项前瞻性单中心流行病学放射学研究。分析了 2010 年 1 月至 2012 年 5 月因晚期髋关节骨关节炎接受关节置换术治疗的患者的髋关节 X 线片。根据获得的数据对每位患者的骨关节炎病因进行分类（原发性、SCFE、发育不良、髋臼前突、其他）。使用头-颈侧位指数（head-neck lateral index，LVHNI）定量评估股骨头后移，以识别 SCFE 后遗症。
共纳入 186 髋。51 例（27.4%）患者的骨关节炎被认为是原发性，42 例（22.5%）继发于发育不良，38 例（20.5%）继发于髋臼前突，9 例（4.9%）继发于其他疾病，而 46 髋（24.7%）的影像学图像提示存在 SCFE 病史。在年龄<60 岁的患者中，SCFE 畸形是骨关节炎的主要病因（30/84 或 35.7%）。SCFE 组的平均年龄为 56.2 岁（26-80），而原发性骨关节炎组的平均年龄为 66 岁（54-91）（P<0.0001）。SCFE 组的平均 LVHNI 为 13%（9-24%），SCFE 组的平均体重指数为 27.1kg/m2（±3.5；18.2-35.4），男女比例为 7.3/1。
我们的研究发现了一组具有髋关节形态学 SCFE 类型异常的人群（LVHNI>9%），这导致了比人群中其他部位更早的骨关节炎发展。SCFE 比文献报道更常见，因为它是 60 岁以下患者髋关节骨关节炎的首要病因。
III 级。有对照组的前瞻性诊断研究。
