Total hip arthroplasty as treatment for avascular necrosis secondary to slipped capital femoral epiphysis in a pre-teen.
BACKGROUND
While the treatment for avascular necrosis (AVN) secondary to slipped capital femoral epiphysis (SCFE) varies, it is rare that a pre-teenager will undergo a total hip arthroplasty (THA) in efforts to relieve pain and maintain function.


METHODS
A-10-year old female sustained an unstable SCFE while playing on wet grass. Unfortunately, her femoral head demonstrated significant AVN after surgical hip dislocation. All treatment options were discussed with the patient and her family. The decision of the family was to have the patient undergo a THA.


RESULTS
Approximately one year after her injury, a ceramic on ceramic THA was performed. Her post-operative Harris Hip Scores increased dramatically and she was able to walk without crutches for the first time since her injury. At one year post operatively, the patient was no longer taking narcotics, losing weight, and returned to her sporting activities.


CONCLUSIONS
THA for SCFE in pre-teenagers is not a norm and should be considered on a case by case basis. This case report demonstrates a successful outcome and a review of options for the treatment of AVN secondary to SCFE.
Department of Orthopaedics, Tufts Medical Center, Boston, MA, USA.
Jeremie M
JM
Axe
Jessie Osborne
JO
Paull
Eric
E
Smith
D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D002648:Child; D005260:Female; D005270:Femur Head / Q000000981:diagnostic imaging / Q000601:surgery; D005271:Femur Head Necrosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D005500:Follow-Up Studies; D006617:Hip Dislocation / Q000601:surgery; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D011859:Radiography; D060048:Slipped Capital Femoral Epiphyses / Q000150:complications* / Q000000981:diagnostic imaging; D016896:Treatment Outcome