Tactics of Surgical Treatment of Slipped Capital Femoral Epiphysis Associated With Mild Chronic Epiphyseal Displacement
Background. The appearing of data on cam-type FAI in patients with sequelae of slipped capital femoral epiphysis characterized by mild chronic epiphyseal displacement suggests that along with fixation of the proximal femoral epiphysis, modeling of the head-neck transition and restoration of the femo...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | Russian |
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Vreden Russian Research Institute of Traumatology and Orthopedics
2022-12-01
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| Series: | Travmatologiâ i Ortopediâ Rossii |
| Subjects: | |
| Online Access: | https://journal.rniito.org/jour/article/viewFile/1774/1517 |
| _version_ | 1797901559365894144 |
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| author | Dmitriy B. Barsukov Pavel I. Bortulev Vladimir E. Baskov Ivan Yu. Pozdnikin Tatyana V. Murashko Tamila V. Baskaeva |
| author_facet | Dmitriy B. Barsukov Pavel I. Bortulev Vladimir E. Baskov Ivan Yu. Pozdnikin Tatyana V. Murashko Tamila V. Baskaeva |
| author_sort | Dmitriy B. Barsukov |
| collection | DOAJ |
| description | Background. The appearing of data on cam-type FAI in patients with sequelae of slipped capital femoral epiphysis characterized by mild chronic epiphyseal displacement suggests that along with fixation of the proximal femoral epiphysis, modeling of the head-neck transition and restoration of the femoral offsets using arthroscopic techniques should be performed. Meanwhile, it is well known that after epiphyseal fixation, complete remodeling of the epimetaphysis and, consequently, disappearance of the morphological substrate of potential FAI can occur due to the ongoing enchondral and echondral growth. In this regard, the issue of indications for intraarticular interventions in studied patients remains currently open.
The aim of the study was to determine the incidence of FAI in the postoperative period in patients with slipped capital femoral epiphysis characterized by mild chronic epiphyseal displacement, and to estimate the requirement of further surgical treatment.
Methods. The results of the examination of 32 patients with mild chronic epiphyseal displacement in the typical posterior inferior direction who underwent cannulated epiphyseal screw fixation were analyzed for the severity of epimetaphysis remodeling and the presence of FAI in the postoperative period. Clinical, radiological, magnetic resonance, and statistical methods were used.
Results. At the age of 18-19 years, FAI with pain syndrome in everyday life was found in 9 (28.1%) patients 8 of them did not have even partial remodeling of the femoral component of the joint, another 9 (28.1%) patients did not suffer from pain syndrome in everyday life, but had other clinical, radiological and MR signs of cam-type FAI. Complete or almost complete remodeling of the proximal femoral epimetaphysis occurred in 14 (43.8%) patients.
Conclusion. In our opinion, therapeutic and diagnostic arthroscopy of the hip joint for the purpose of modeling the head-neck transition at the age of 18-19 years is indicated for more than one quarter (28.1%) of the investigated patients because of the presence of reliable signs of FAI. |
| first_indexed | 2024-04-10T09:03:50Z |
| format | Article |
| id | doaj.art-e8415510052c4315b7f2189428fe8030 |
| institution | Directory Open Access Journal |
| issn | 2311-2905 2542-0933 |
| language | Russian |
| last_indexed | 2024-04-10T09:03:50Z |
| publishDate | 2022-12-01 |
| publisher | Vreden Russian Research Institute of Traumatology and Orthopedics |
| record_format | Article |
| series | Travmatologiâ i Ortopediâ Rossii |
| spelling | doaj.art-e8415510052c4315b7f2189428fe80302023-02-21T09:41:31ZrusVreden Russian Research Institute of Traumatology and OrthopedicsTravmatologiâ i Ortopediâ Rossii2311-29052542-09332022-12-012849010110.17816/2311-2905-17741234Tactics of Surgical Treatment of Slipped Capital Femoral Epiphysis Associated With Mild Chronic Epiphyseal DisplacementDmitriy B. Barsukov0https://orcid.org/0000-0002-9084-5634Pavel I. Bortulev1https://orcid.org/0000-0003-4931-2817Vladimir E. Baskov2https://orcid.org/0000-0003-0647-412XIvan Yu. Pozdnikin3https://orcid.org/0000-0002-7026-1586Tatyana V. Murashko4https://orcid.org/0000-0002-0596-3741Tamila V. Baskaeva5https://orcid.org/0000-0001-9865-2434H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma SurgeryH. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma SurgeryH. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma SurgeryH. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma SurgeryH. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma SurgeryH. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma SurgeryBackground. The appearing of data on cam-type FAI in patients with sequelae of slipped capital femoral epiphysis characterized by mild chronic epiphyseal displacement suggests that along with fixation of the proximal femoral epiphysis, modeling of the head-neck transition and restoration of the femoral offsets using arthroscopic techniques should be performed. Meanwhile, it is well known that after epiphyseal fixation, complete remodeling of the epimetaphysis and, consequently, disappearance of the morphological substrate of potential FAI can occur due to the ongoing enchondral and echondral growth. In this regard, the issue of indications for intraarticular interventions in studied patients remains currently open. The aim of the study was to determine the incidence of FAI in the postoperative period in patients with slipped capital femoral epiphysis characterized by mild chronic epiphyseal displacement, and to estimate the requirement of further surgical treatment. Methods. The results of the examination of 32 patients with mild chronic epiphyseal displacement in the typical posterior inferior direction who underwent cannulated epiphyseal screw fixation were analyzed for the severity of epimetaphysis remodeling and the presence of FAI in the postoperative period. Clinical, radiological, magnetic resonance, and statistical methods were used. Results. At the age of 18-19 years, FAI with pain syndrome in everyday life was found in 9 (28.1%) patients 8 of them did not have even partial remodeling of the femoral component of the joint, another 9 (28.1%) patients did not suffer from pain syndrome in everyday life, but had other clinical, radiological and MR signs of cam-type FAI. Complete or almost complete remodeling of the proximal femoral epimetaphysis occurred in 14 (43.8%) patients. Conclusion. In our opinion, therapeutic and diagnostic arthroscopy of the hip joint for the purpose of modeling the head-neck transition at the age of 18-19 years is indicated for more than one quarter (28.1%) of the investigated patients because of the presence of reliable signs of FAI.https://journal.rniito.org/jour/article/viewFile/1774/1517slipped capital femoral epiphysiship jointfemoroacetabular impingementhip arthroscopy |
| spellingShingle | Dmitriy B. Barsukov Pavel I. Bortulev Vladimir E. Baskov Ivan Yu. Pozdnikin Tatyana V. Murashko Tamila V. Baskaeva Tactics of Surgical Treatment of Slipped Capital Femoral Epiphysis Associated With Mild Chronic Epiphyseal Displacement Travmatologiâ i Ortopediâ Rossii slipped capital femoral epiphysis hip joint femoroacetabular impingement hip arthroscopy |
| title | Tactics of Surgical Treatment of Slipped Capital Femoral Epiphysis Associated With Mild Chronic Epiphyseal Displacement |
| title_full | Tactics of Surgical Treatment of Slipped Capital Femoral Epiphysis Associated With Mild Chronic Epiphyseal Displacement |
| title_fullStr | Tactics of Surgical Treatment of Slipped Capital Femoral Epiphysis Associated With Mild Chronic Epiphyseal Displacement |
| title_full_unstemmed | Tactics of Surgical Treatment of Slipped Capital Femoral Epiphysis Associated With Mild Chronic Epiphyseal Displacement |
| title_short | Tactics of Surgical Treatment of Slipped Capital Femoral Epiphysis Associated With Mild Chronic Epiphyseal Displacement |
| title_sort | tactics of surgical treatment of slipped capital femoral epiphysis associated with mild chronic epiphyseal displacement |
| topic | slipped capital femoral epiphysis hip joint femoroacetabular impingement hip arthroscopy |
| url | https://journal.rniito.org/jour/article/viewFile/1774/1517 |
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