Revista de Medicina Desportiva (English) September 2018 | Page 31

Sociedade Portuguesa de
Artroscopia e Traumatologia
Desportiva
Rev. Medicina Desportiva informa, 2018; 9(5):29–31.
Slipped Capital Femoral
Epiphysiolysis and
Concomitant Symptomatic
Femoroacetabular
Impingement in a Young
Footballer
demand, as is the case of competi-
tive sport. 7 The authors had found
out that even on the slight SCFE the
residual deformity leads to signifi-
cant injuries of the cartilage and of
acetabular labrum in 75-100% of
cases, they can be found after one
year 3 , and they recommend early
femoral neck osteoplasty in order to
reduce the risk of secondary osteo-
arthritis. 5
Dr. André Miguel Costa 1 , Dr. Eurico Bandeira Rodrigues 2
1
Resident; 2 Specialist. Orthopedics and traumatology. Braga Hospital. Portugal
Methods
ABSTRACT
Slipped capital femoral epiphysis is a known cause of cam-type femoro-acetabular impingement,
which may lead to early hip osteoarthrosis. We present a case of a slipped capital femoral epiphysis
in a young football player with a chronic clinical presentation who later developed femoro-acetabular
impingement symptoms. In the same surgical approach was submitted to in situ percutaneous fixa-
tion and arthroscopic osteoplasty of the femoral neck. Six weeks later he gradually returned to high
level competition and, after two years of follow-up, continues free of symptoms in football practice.
KEYWORDS
Slipped capital femoral epiphysis, femoroacetabular impingement, sports
Introduction
Slipped capital femoral epiphysis
(SCFE) is one of the most frequents
pathologies of the young hip, where
there is a posteromedial slip of the
femoral head through the physis. 1 In
situ fixation is the standard treat-
ment of SCFE, promoting the physis
closure, preventing a greater slip 2
and the worsening of anterolateral
prominence of the femoral meta-
physis. 3
The natural history of the dis-
ease is controversial. 1 Babu and al
described some remodeling potential
of the deformity as an explanation
for the good results ten to twenty
years after isolated in situ fixation in
most less active patients. 4 However,
It is described the case of a 14-year-
old male elite football player with
chronic SCFE and secondary FAI. He
was referred because of an insidious
pain in the left hip lasting for three
months and also referring similar
complaints one year before.
At clinical examination he had a
limping gait, preferential external
rotation of the hip with passive
flexion, decreased internal rotation
and a positive impingement test. An
x-ray was performed, and it revealed
an open proximal femoral physis
and a left SCFE, with a slight angle
of Southwick of 26° (Figures 1 and
2). The MRI showed a cam type FAI
the SCFE creates a secondary cam
type femoroacetabular impinge-
ment (FAI), where there is a contact
between the deformity of femoral
neck joint and the acetabular rim. 5,6
The untreated
FAI leads to early
articular dam-
age and osteoar-
thritis. Usually,
the symptoms
start in adult-
hood, but they
have been more
recognized in
the paediatric
population and
may be precipi-
tated by exces-
sive physical
Figure 1 – Anteroposterior X-ray of the pelvis: SCFE on the left
Revista de Medicina Desportiva informa september 2018 · 29