Slipped Capital Femoral Epiphyses
What is a Slipped Capital Femoral Epiphysis (SCFE)?
Slipped Capital Femoral Epiphysis, often abbreviated as SCFE or SUFE, is a hip disorder that primarily affects adolescents between the ages of 9 and 15. It occurs when the growth plate at the upper end of the thigh bone (femur) slips or separates from the rest of the bone of the hip joint.
How is a slipped capital femoral epiphysis diagnosed?
Diagnosis of SCFE revolves around a detailed medical history, examination and x-rays. Often in severe cases further advanced imaging may be necessary including CT scans, bone scans and MRI scans. Early diagnosis is crucial for best treatment outcomes.
This condition can lead to symptoms such as:
- Hip or groin pain: persistent pain in the hip or groin area, often radiating to the thigh
- Limping: noticeable limp or change in walking pattern
- Stiffness: decreased or noticeable reduction in range of motion
- Knee pain: some patients experience knee pain due to the referred pain from the hip
The exact cause of SCFE is not always clear, but several factors may contribute:
- Endocrine disorders - certain hormonal conditions may increase the risk
- Growth spurt - rapid growth during adolescence may increase the risk
- Obesity - being overweight can put additional stress on the growth plate, increasing the likelihood of slipping
- Genetics - family history may play a role in predisposition
How is a slipped capital femoral epiphysis treated?
Treatment goals are to stabilise the hip joint and prevent further slippage and are typically surgical, requiring surgical pinning of the growth plate. In severe cases, further surgery may be required to redirect and realign the femoral head in the hip joint, trim excess bone, or address secondary hip issues. Following surgical treatment, there is usually a long period (weeks to months) of non-weight bearing or modified activity. It is usual for the patient to be off sport for many months following a SCFE.
Dr Eardley-Harris has been extensively trained and has experience in both diagnosis, and treatment of SCFE including operative intervention, and will discuss with you further details specific to you or your child's hip. Dr Eardley-Harris also has extensive experience in treating the long term complications of SCFE including hip realignment surgery, hip impingement surgery or even hip replacement at a young age (young adult or adolescent).
After SCFE, there is a risk of a SCFE developing in the other hip, and Dr Eardley-Harris may discuss with you the consideration of surgical pinning of the other hip prior to it developing SCFE, particularly if you are at a high risk.
The prognosis of SCFE depends on the severity of the slippage and the age of the patient. Some complications of SCFE may require further surgery as time progresses. This can include a risk of avascular necrosis which leads to collapse of the hip, arthritis, pain and loss of motion. Other complications include bony deformity or impingement resulting in realignment surgery to restore function to the hip. Sometimes the deformity is too great or the damage to the hip from SCFE is so severe that hip replacement needs to be considered down the line.
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Meet Nathan
He has subspecialty, post-fellowship training in hip preservation surgery and joint replacement, including robotic & technology-assisted surgery across all approaches, including the direct anterior approach. Through compassion, communication, collaboration & competence, Nathan aims to build patient-surgeon trust, helping you understand your condition and the options available to empower you to make better treatment decisions toward your personal recovery goals. With stronger, better-informed patient-surgeon relationships, evidence-based surgical techniques and the latest assistive technology, Nathan aims to provide patients with the best possible care.
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