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Topic:

Anterior Cruciate Ligament

Issue:

Knee

Category:

​

Title:

Quantifying Risk Factors for Slipped Capital Femoral Epiphysis and Postslip Osteonecrosis

Author:

Zusman, Natalie L. MD; Goldstein, Rachel Y. MD, MPH; Yoo, Jung U. MD

Journal:

Journal of Pediatric Orthopaedics

Date:

January 2024

Reference:

44(1): p e30-e34, DOI: 10.1097/BPO.0000000000002539

Level Of Evidence:

IV

# of Patients:

SCFE group: 11,465 patients
Control group: 134,680 patients

Study Type:

Retrospective cohort study

Location:

United States

Summary:

This study identifies risk factors for developing slipped capital femoral epiphysis (SCFE) and postslip osteonecrosis (ON) using a national database. The study aims to quantify the association between comorbidities and the development of SCFE and ON.

Methods:

Inclusion Criteria: Pediatric patients diagnosed with SCFE between 2010 and 2020. Exclusion Criteria: Not specified. Intervention: Analysis of national database for patients with SCFE and associated comorbidities. Outcomes Measured: Risk Factors for SCFE: Obesity, vitamin D deficiency, hypothyroidism, growth hormone use. Risk Factors for Postslip ON: Vitamin D deficiency, hypothyroidism. Data Source: PearlDiver Technologies, Inc. database, with International Classification of Disease codes (2010 to 2020).

Exclusions:

Not specified

Results:

Risk Factors for SCFE: Obesity: Relative risk (RR) = 3.45 (95% CI: 3.33-3.57) Vitamin D deficiency: RR = 1.42 (95% CI: 1.21-1.39) Hypothyroidism: RR = 1.53 (95% CI: 1.17-2.01) Growth hormone use: RR = 1.53 (95% CI: 1.21-1.93) Risk Factors for Postslip ON: Vitamin D deficiency: RR = 1.65 (95% CI: 1.26-2.14) Hypothyroidism: RR = 1.49 (95% CI: 1.10-2.07)

Conclusions:

Obesity is the most significant risk factor for the development of SCFE, while vitamin D deficiency, hypothyroidism, and growth hormone use are also risk factors for SCFE. Vitamin D deficiency and hypothyroidism are risk factors for postslip osteonecrosis (ON). These findings underscore the importance of addressing obesity and comorbid conditions in pediatric hip pathology.

Relevance:

Limitations:

Perspective:

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