Garcia Larissa Martins, Angélico Ana Cecília Capoani, Serenza Felipe DE Souza, Volpon José Batista, Maranho Daniel Augusto
Universidade de São Paulo, Ribeirão Preto Medical School, Department of Orthopaedics and Anesthesiology, Ribeirão Preto, SP, Brazil.
Acta Ortop Bras. 2022 Nov 11;30(5):e257002. doi: 10.1590/1413-785220223005e257002. eCollection 2022.
To compare the clinical outcomes between patients with moderate and severe slipped capital femoral epiphysis (SCFE) treated with osteotomy at the base of neck and osteoplasty and with healthy individuals.
Comparative cohort with 12 patients (14 hips) with moderate and severe SCFE who underwent osteotomy at the base of neck and osteoplasty between 2007 and 2014. The mean age at surgery was 13.3 ± 2.5 years and the mean follow-up was 3.8 ± 2.2 years. We assessed the level of hip pain by the visual analog scale (VAS) and anterior impingement test (AIT); the level of function using the Harris Hip Score (HHS) and 12-Item Short Form Health Survey (SF-12), the range of motion (ROM) by goniometry and Drehmann sign, and the hip muscular strength by isokinetic and Trendelenburg sign.
The level of pain was slightly higher in the SCFE cohort compared with healthy hips (VAS, 0.8 ± 1.4 vs 0 ± 0, 0.007; AIT, 14% vs 0%, p = 0.06; respectively). No differences were observed between the SCFE and control cohort for the functional scores (HHS, 94 ± 7 vs 100 ± 1, p = 0.135); except for ROM, with increased internal rotation (37.3º ± 9.4º vs 28.7º ± 8.2º, p < 0.001), and strength, with decreased abduction torque (75.5 ± 36.9 Nm/Kg vs 88.5 ± 27.6 Nm/Kg, p = 0.045) in the SCFE cohort.
The osteotomy at the base of neck and the osteoplasty restored the hip motion and muscle strength, except for the abductor strength, to near normal levels, representing a viable option for the treatment of moderate and severe SCFE.
比较采用股骨颈基底截骨术和骨成形术治疗的中度和重度股骨头骨骺滑脱（SCFE）患者与健康个体的临床结局。
对2007年至2014年间接受股骨颈基底截骨术和骨成形术的12例（14髋）中度和重度SCFE患者进行比较队列研究。手术时的平均年龄为13.3±2.5岁，平均随访时间为3.8±2.2年。我们通过视觉模拟量表（VAS）和前撞击试验（AIT）评估髋关节疼痛程度；使用Harris髋关节评分（HHS）和12项简短健康调查（SF-12）评估功能水平，通过量角器和德雷曼征评估活动范围（ROM），通过等速运动和单足站立试验评估髋关节肌肉力量。
与健康髋关节相比，SCFE队列中的疼痛程度略高（VAS，0.8±1.4对0±0，P=0.007；AIT，14%对0%，P=0.06）。SCFE队列与对照组在功能评分方面未观察到差异（HHS，94±7对100±1，P=0.135）；除ROM外，SCFE队列中内旋增加（37.3°±9.4°对28.7°±8.2°，P<0.001），力量方面外展扭矩降低（75.5±36.9 Nm/Kg对88.5±27.6 Nm/Kg，P=0.045）。
股骨颈基底截骨术和骨成形术将髋关节活动度和肌肉力量（外展肌力量除外）恢复到接近正常水平，是治疗中度和重度SCFE的可行选择。
