Contemporary Total Hip Arthroplasty for Sequelae of Slipped Capital Femoral Epiphysis: 15-Year Outcomes of 165 Cases.

Abstract

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. 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). The 15-years 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). In the largest reported series on this topic to our knowledge, contemporary THA for sequelae of SCFE demonstrated excellent 15-years survivorship free of revision and reoperation, along with clinical improvements in this unique population.