Arthroscopic subcapital realignment osteotomy in the treatment of chronic and stable proximal femoral epiphysiolysis: Early results

Bruno Dutra Roos, Marcelo Camargo de Assis, Milton Valdomiro Roos, Antero Camisa Júnior, Ezequiel Moreno Ungaretti Lima, Rodolfo Cavanus Pagani

Article ID: 1739
Vol 4, Issue 1, 2021, Article identifier:84-91

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Abstract


Objective: To evaluate the clinical and radiographic results and complications of arthroscopic subcapital realignment osteotomy for the treatment of chronic and stable proximal femoral epiphysiolysis (PFE) in an initial series of patients. According to the literature review, the study presents the first description of an arthroscopic technique of this type of osteotomy. Methods: Between June 2012 and December 2014, seven patients underwent arthroscopic subcapital realignment osteotomy for the treatment of chronic, stable PFE. The mean age of the patients was 11 years and four months. Minimum follow-up ranged from 6 to 36 months (mean, 16.5 months). Patients were clinically evaluated according to the Harris Hip Score modified by Byrd and radiographically according to Southwick’s quantitative classification and the epiphyseal-diaphyseal angle. Postoperative complications were analyzed. Results: With regard to the evaluation of the Harris Hip Score Modified by Byrd clinical score, a preoperative mean of 35.8 points and a postoperative mean of 97.5 points were observed (p < 0.05). Radiographically, five patients were classified as Southwick grade II and two as grade III. A mean correction of the epiphyseal-diaphyseal angle of 40° was observed. There were no immediate postoperative complications. One patient developed avascular necrosis of the femoral head, without collapse or chondrolysis at the last follow-up (22 months). Conclusion: The arthroscopic technique presented by the authors for the treatment of chronic, stable PFE resulted in clinical and radiographic improvement of the patients in this initial series.


Keywords


Displaced Epiphysis; Hip; Femoral Head; Arthroscopy; Child

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References


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DOI: http://dx.doi.org/10.24294/irr.v4i1.1739

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