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Case Report
Adult case of slipped capital femoral epiphysis initially requiring in situ fixation with revision to total hip arthroplasty after failure of index surgery
1 MD, UCF/HCA Consortium, Resident, Graduate Medical Education Department of Orthopedic Surgery, HCA Florida Ocala Hospital, Ocala, FL, USA
2 DO, UCF/HCA Consortium, Resident, Graduate Medical Education Department of Orthopedic Surgery, HCA Florida Ocala Hospital, Ocala, FL, USA
3 MD, UCF/HCA Consortium, Attending Physician, Graduate Medical Education Department of Orthopedic Surgery, HCA Florida Ocala Hospital, Ocala, FL, USA
Address correspondence to:
Kyle Mahoney
MD, 514 NE 40th Ave, Ocala, FL 34470,
USA
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Article ID: 100029Z14KM2024
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How to cite this article
Mahoney K, Lee-Norris A, Romero A, McFadden J. Adult case of slipped capital femoral epiphysis initially requiring in situ fixation with revision to total hip arthroplasty after failure of index surgery. J Case Rep Images Orthop Rheum 2024;7(1):1–4.ABSTRACT
Introduction: Slipped capital femoral epiphysis (SCFE) is a disorder classically associated with pediatric patients in which the femoral head is displaced through the physis. In rare cases of metabolic and hormonal disorders, SCFEs can be identified in adult patients as a result of persistent growth plates. Optimal definitive surgical management of these patients is still unknown and more information is needed in order to provide appropriate care for these patients.
Case Report: A 31-year-old male with past medical history of hypopituitarism presented with left hip pain after a seizure. He was found to have a left slipped capital femoral epiphysis on initial radiographs for which he was taken to the operating room for open treatment of the left SCFE with in situ screw fixation. Approximately four weeks later he returned to the hospital after a fall with left hip pain and inability to ambulate. Radiographs demonstrated cutout of the cannulated screw in the setting of a SCFE with further displacement. He returned to the operating room for conversion to an uncemented total hip arthroplasty. His post-op course was uneventful and he was discharged home in stable condition.
Conclusion: This cases highlights a condition uncommonly identified in adult patients which was further complicated by failure of the initial surgical repair and need for revision surgery. This case is unique in that total hip arthroplasty as a definitive treatment for acute SCFE, rather than treatment for end stage arthritis secondary to chronic SCFE, has not been reported upon this author’s review.
Keywords: Adult, Epiphysis, Hypopituitarism, Revision, Slipped
SUPPORTING INFORMATION
Author Contributions
Kyle Mahoney - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Alexandria Lee-Norris - Substantial contributions to conception and design, Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published
Andrew Romero - Substantial contributions to conception and design, Analysis of data, Revising it critically for important intellectual content, Final approval of the version to be published
James McFadden - Substantial contributions to conception and design, Analysis of data, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2024 Kyle Mahoney et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
