Arthroscopic femoral osteoplasty in patients with slipped capital femoral epiphysis

A recently published paper in the journal Arthroscopy describes a study whose purpose was to assess the outcome of femoral osteoplasty by hip arthroscopy in patients with slipped capital femoral epiphysis who had symptoms of the femoroacetabular impingement type. 37 consecutive patients with a history of slipped capital femoral epiphysis, who underwent hip arthroscopy for femoral osteoplasty over a period of four years, were assessed retrospectively. To assess the lesions, the slip angles, the alpha angle and internal rotation in flexion were measured. The patients were assessed for pain, for functional limitation and for the external rotation abnormality at each review. The mean time to review was 22 months. The results of 34 hips were analysed in all. The lesions of the articular cartilage and of the labrum were considered to have been caused by impingement against the prominent bone of the slip. The goals of complete resolution of pain and of correction of the external rotation abnormality were achieved in 88%. A statistically significant improvement in the alpha angle and in internal rotation in flexion was found. The authors concluded that femoral osteoplasty by hip arthroscopy is effective in reducing pain and in improving the alpha angle and also the external rotation angle in mild to moderate slipped capital femoral epiphysis. However, increased body weight, scarring from previous operations and the presence of screws are difficulties and challenges during the arthroscopic technique.