What options are available for decreased mobility after pinned capital femoral ephysis?

Hi. Thanks for your reply. 

It was a bad slip on my right side I was pretty much limping rocking from one side to the other. I don't believe I had Avascular Necrosis. 

What treatment options have you encountered thus far?

I am only just looking into this now and scanning dozens of medical journals is a bit much. I'm going to see my orthopedic surgeon soon, thats if he's still practicising lol. 

I'll definitely check out the facebook page. 

Simon

My son was nearly 11 when it happened, he is now 13 and 1/2 and is still on crutches, as his slip was so bad he has avascular necrosis.  Our only option will be a hip replacement as soon as he has stopped growing, but just trying other surgery to try and put this off for a few years.

Orthopaedics can be very reluctant to do the op as you are so young and replacements only last for so long, but if you are fit and not overweight, replacements should apparently last 10 or 15 years.  Problem is that you can only have a limited number of replacements.

I am presuming that you now have arthritis in both hips and are in alot of pain.  I was in touch with someone recently who advised that if your consultant refuses hip surgery that go to one of the larger Orthopaedic hospitals and ask your GP for a referral there are second opinion.

Where are you in the UK?

 

I am actually in Australia.

I have no pain, just a lack of flexibility by way of rotation of the hip joint which stops me from doing a few things I would like to do. 

I can't believe that, 13 years on, they still have not found a better treatment for this. All the best for your son. 

No, there is nothing, even the consultant had perthes disease as a child (causes a mis-shaped femoral head due to the blood supply being cut off and therefore arthritis in later life)and he was saying that everyone just follows the 'holy grail' to finding a permanent hip replacement solution.  Hoping to come out to Oz and visit family there soon. Good luck and do join the facebook page.

Hi, and sorry to hear of your experiences.  Good advise regarding physio.  We have physio nearly every week and swimming, although the hydrotherapy is brilliant if you have access to this.  Still hasn't helped my son to walk again, but just have to keep on trying.

Thank you so much, i am going to try it and hopefully it helps. All the best with your son.

Hi Angela

Where do you live? are you in the UK?

Why would she need re-alignment surgery when older? This would be hard to do if the growth plates have been fused together - as they would have been if they have been pinned, usually realignment is done during the SUFE operation (I understand).  If the leg is out of shape with the hip, it is very difficult for further operations and hip replacements when she gets older and has early onset arthritis (which usually happens with all SUFE patients unfortunately).

Why don't you seek a second opinion from another Consultant?

Good luck

 

Hi ,

Yes we are in the uk we are uder Addenbrookes .

My consultant explained to us that he does not realign at the same time as pinning as this can increase the risk of necrosis. If the slip is only slight some people do not need realignment . In the case of my daughter the left side was a much worse slip then the right and this is the leg she has problems with. She is still limping and her left foot turns out when walking she can not run . The reason my consultant gave for waiting is that even thou the surgery would be more compicated after the growth plate has fused it reduces the  risk of effecting growth as if he done it now she would stay the height of a ten year old for the rest of her life. We are tryingto hold on and help her to cope for as long as we can.

Hi Angela

Do you want to go to our facebook page SUFE Slipped Upper Femoral (capital) Ephiphysis for some more advice?  That is just not right that she would not have continued to grow!  She would have lost growth at the growth plates that have been fused together, (at the femoral head), but she would still have grown at her knees/ankle growth plates.  She may have lost an inch or so (depending on how tall she would have been).  The consultant needs to do a specialist operation to re-align - and my understanding is that there are only othopaedic consultants who can do this are in Southampton, Bristol, London (presume Great Ormand Street), Notts, Royal Stoke University Hospital, Birmingham and Sheffield.

Please do join the facebook group.

Good luck