Outcome of secondary intertrochanteric osteotomy for residual deformity after slipped capital femoral epiphysis.

Abstract

BackgroundAlthough <i>in situ</i> pinning (ISP) is the standard primary treatment for slipped capital femoral epiphysis (SCFE), some patients are left with residual deformity that may lead to long-term complications, including an increased risk of osteoarthritis. This study evaluates the radiographic and clinical outcomes of a secondary corrective procedure, the Pre-Operative computed Tomography-assisted intertrochanteric Flexion (POTOF) osteotomy, for treating these persistent deformities.MethodsWe retrospectively reviewed patients who underwent a POTOF osteotomy as a secondary procedure for SCFE between 2004 and 2020. Patients with less than two years of follow-up were excluded. We evaluated changes in the modified β angle, incidence of avascular necrosis (AVN), relative joint space (RJS), and the modified Harris Hip Score at the final follow-up. Statistical significance was set at p < 0.05.ResultsEleven patients (nine male, two female; 11 hips) were included, with a mean follow-up of 9.0 years. Seven patients had undergone prior ISP, and four were neglected cases. The mean modified β angle significantly improved from 120° to 91° (p < 0.01). No AVN was observed. The mean RJS was 92% (range, 42-128%). The mean modified Harris Hip Score, available for 7 of the 11 hips, was 92.4, indicating good hip function.ConclusionsThe POTOF osteotomy may serve as a viable secondary procedure for treating residual deformities after SCFE. In this small cohort it improved hip alignment and function, supporting its potential as a treatment option for patients with post-SCFE deformities or neglected cases, although further comparative studies are required to confirm its definitive efficacy.