JOA - 2026-04-09 - Journal Article
Contemporary Total Hip Arthroplasty for Sequelae of Slipped Capital Femoral Epiphysis: 15-Year Outcomes of 165 Cases.
Guarin Perez SF, Chen AG, Restrepo DJ, Tai TW, Taunton MJ, Pagnano MW, Trousdale RT, Berry DJ, Sierra RJ
Topics
Key Takeaway
Contemporary THA for SCFE sequelae achieves 98% 15-year survivorship free of aseptic revision with Harris Hip Score improving from 57.1 to 89.2 at 10 years.
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Summary
This study evaluated survivorship, complications, and functional outcomes of 165 THAs performed for SCFE sequelae between 2000 and 2022 at a mean patient age of 45 years with 81% having prior surgical treatment. Cementless fixation was used in 96% and ceramic-on-HXLPE in 47%. At 15 years, survivorship free of aseptic revision was 98%, free of any complication was 89%, and HHS improved from 57.1 to 89.2 (p<0.001) with no radiographic loosening in unrevised hips.
Key Limitation
The absence of a matched control cohort of primary OA THA patients of similar age and BMI prevents determination of whether SCFE-related anatomic distortion independently affects survivorship or complication rates.
Original Abstract
BACKGROUND
Slipped capital femoral epiphysis (SCFE) is a pediatric hip disorder whose sequelae may require total hip arthroplasty (THA) at a young age. The outcomes of contemporary THA in this population need to be defined further. We aimed to evaluate survivorship, complications, radiographic results, and clinical outcomes in this population.
METHODS
We identified 165 THAs performed for sequelae of SCFE between 2000 and 2022. The mean age at THA was 45 years, 71% were men, and they had a mean body mass index of 33. There were 133 hips (81%) with prior surgical treatment, most commonly in situ pinning (58%). Most THA constructs used cementless fixation (96%). Ceramic-on-highly cross-linked polyethylene was the most common bearing surface (47%). The mean follow-up was nine years (range, two to 21).
RESULTS
The 15-year survivorships free of aseptic revision, any revision, any reoperation, and any complication were 98, 98, 96, and 89%, respectively. There were three revisions performed for aseptic loosening, liner dissociation, and periprosthetic joint infection. Of 12 complications, 11 occurred within 30 days of THA. In unrevised THA, there was no evidence of loosening at final follow-up. The mean Harris Hip Score improved from 57.1 preoperatively to 89.2 at 10 years (P < 0.001).
CONCLUSIONS
In the largest reported series on this topic to our knowledge, contemporary THA for sequelae of SCFE demonstrated excellent 15-year survivorship free of revision and reoperation, along with clinical improvements in this unique population.