title: Patient-Reported Health Outcomes After in Situ Percutaneous Fixation for Slipped Capital Femoral Epiphysis: An Average Twenty-Year Follow-up Study.
abstract: BACKGROUND
  Percutaneous in situ fixation is the gold-standard treatment for stable slipped capital femoral epiphysis (SCFE). While numerous studies have documented good to excellent long-term clinical and radiographic outcomes, few have documented long-term patient-reported outcomes of patients with this condition.
  
  
  METHODS
  This retrospective study was performed to document long-term patient-reported outcomes of a cohort of sixty-four patients with SCFE (ninety-one affected hips) and determine whether the slip angle was associated with poorer health outcomes as measured with the Short Form-12 (SF-12) Physical Component Summary (PCS) and Mental Component Summary (MCS) scores, modified Harris hip score (mHHS), and University of California at Los Angeles (UCLA) Activity Scale.
  
  
  RESULTS
  The mean age at presentation was 12.6 years, and the mean duration of follow-up was 19.6 years. At the time of follow-up, the cohort reported higher rates of diabetes, obesity, and hypertension than the general U.S.
  
  
  METHODS
  The mean body mass index (BMI) had increased by 10.2 kg/m(2), with 72% of the subjects meeting the criteria for obesity (BMI > 30 kg/m(2)) at the time of follow-up. The mean age and sex-adjusted PCS and MCS scores were 49.6 and 50.0, respectively, and the mean mHHS was 84.9. Multivariable general linear modeling revealed no association between the initial slip angle and the PCS, MCS, mHHS, or UCLA Activity Scale score. Male sex and a lower BMI were the only predictors of better long-term PCS, mHHS, and UCLA Activity Scale scores. Subjects with a bilateral slip had outcomes similar to those with unilateral disease.
  
  
  CONCLUSIONS
  The general self-reported health of this cohort was poor compared with that of the general population. The slip angle on presentation did not correlate with any patient-reported outcome measure collected for this study. Higher BMI was one of the only clinical predictors of patient-reported outcomes.
authors.affiliation: Department of Orthopedic Surgery, Children's Hospital of Wisconsin, 9000 West Wisconsin Avenue, Suite C-360, Milwaukee, WI 53226. E-mail address: BEscott@chw.org.
authors.forename: Benjamin G
authors.initials: BG
authors.lastname: Escott
authors.affiliation: Department of Orthopaedic Surgery, Texas Scottish Rite Hospital for Children, 2222 Welborn Street, Dallas, TX 75219.
authors.forename: Adriana
authors.initials: A
authors.lastname: De La Rocha
authors.affiliation: Department of Orthopaedic Surgery, Texas Scottish Rite Hospital for Children, 2222 Welborn Street, Dallas, TX 75219.
authors.forename: Chan-Hee
authors.initials: CH
authors.lastname: Jo
authors.affiliation: Department of Orthopaedic Surgery, Texas Scottish Rite Hospital for Children, 2222 Welborn Street, Dallas, TX 75219.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Sucato
authors.affiliation: Department of Orthopaedic Surgery, Texas Scottish Rite Hospital for Children, 2222 Welborn Street, Dallas, TX 75219.
authors.forename: Lori A
authors.initials: LA
authors.lastname: Karol
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006305:Health Status Indicators; D006801:Humans; D016014:Linear Models; D008297:Male; D019637:Orthopedic Procedures / Q000379:methods*; D063868:Patient Outcome Assessment; D011859:Radiography; D012189:Retrospective Studies; D060048:Slipped Capital Femoral Epiphyses / Q000000981:diagnostic imaging / Q000601:surgery*; D055815:Young Adult