Researcher of study on SCFE patients highlights importance of early weight management

LAS VEGAS — A 20-year follow-up of pediatric patients who underwent in-situ fixation for slipped capital femoral epiphysis shows many patients had poor health and patient-reported outcomes did not significantly correlate with the initial slip angle, according to data presented at the American Academy of Orthopaedic Surgeons Annual Meeting.

“The general health of our patients is poor compared to the general population,” Lori A. Karol, MD, said. “The BMI has shown a large increase from presentation to follow-up, and many of these patients start heavy to begin with. It is a consistent predictor of poor patient-reported health outcomes across our measures. Interestingly, the males seem to report better health outcomes than our females did, and our baseline slip angle and grade correlated poorly with all patient-reported outcomes.”

She added, “Weight management after presentation of for slipped capital femoral epiphysis [SCFE] may be the most important service that we can provide in the overall outcome of these patients.”

Karol and colleagues conducted a cross-sectional study and retrospectively reviewed the charts of 66 patients for a total of 93 hips with mild to moderate SCFE, according to the study abstract. Diabetes was present in 7.6% of patients with SCFE by an average age of 32 years. Karol noted 16.6% reported high blood sugar at some time, which is two-times higher than the U.S. average. Hypertension was present in 15%, which was 2.6-times higher than the U.S. average. Patients also complained of chest pain and noted that their health interfered with their job performance. A quarter of patients reported their health as fair or poor.

“Their BMI at the time of presentation was either healthy or overweight in the majority of patients,” Karol said. “But, at follow-up, we see a shift toward an increase in BMI by 10 points.”

Patients had average SF-12 physical component (PCS) and mental component scale scores of 49 and 50, respectively. Their average modified Harris Hip score (mHHS) was 84.4 and their UCLA Activity Scale score was 7.2.

While none of the patient-reported outcome measures significantly correlated with the initial slip angle, investigators found a statistically significant association between male gender and decreased BMI and the SF-12 PCS score. Similarly, the study showed that both mHHS and UCLA Activity Scale scores were significantly associated with male gender and decreased BMI. – by Gina Brockenbrough, MA

Reference:

Karol LA, et al. Paper #631. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 23-28, 2015; Las Vegas.

Disclosure: Karol reports no relevant financial disclosures.