Slipped capital femoral epiphysis (SCFE) and Legg-Calve-Perthes (LCP) disease are developmental conditions (1, 2) with SCFE being described as a common source of pain and disability, and the most common cause of degenerative hip disease in middle-aged patients (3, 4). Proximal femoral osteotomies following SCFE aim to restore more normal anatomy, improve function and reduce the morbidity and complications of pain, reduced range of movement, early arthritis and leg length discrepancy (3). Up to 50% of involved hips do well with no intervention but these hips are always at risk of developing secondary arthritis and similarly adult hip joints of patients with SCFE are more prone to develop advanced osteoarthritis (5). In general outcomes of osteotomies are associated with more than 50% morbidity (6) and significant complications (7-11).
The management of end stage arthritis in patients with LCP and SCFE is total hip replacement (12). In young patients with end stage arthritis following SCFE and LCP, good prognosis and an implant survival rate of 80% at a follow-up of 10 years has been reported for Charnley prosthesis in the Norwegian arthroplasty register (13). Other studies have reported similar implant survival ranging from 78.1% to 90.7 % (14, 15), which is encouraging but is compounded by problems arising from an active lifestyle such as early failure and revision. The average age in these published reports was 50 years which means that 10 to 20% patients will undergo a revision at 60 years of age and further re-revision surgery there after.
Due to its bone conserving nature, ability to confer joint stability and ease of conversion to a total hip replacement in the event of implant failure, hip resurfacing arthroplasty is gaini...
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...t caution towards generalization of these findings as hip resurfacing is a new procedure and majority of surgeons are in learning phase(27, 28). This is a clinical study therefore lack of radiological follow-up is a limitation in our report. We collect annual hip scores and it has been reported that subjective outcome measures have a high correlation with signs of radiological loosening (29-31). By combining a subjective outcome measure and actual loosening rates, the results from this study will therefore be useful even in the absence of radiological data.
Given the altered and challenging anatomy in these patients and technical difficulties of the procedure plus a high activity level of these patients, we consider our results to be encouraging. We would recommend hip resurfacing as a viable alternative to patients with secondary arthritis following LCP/SCFE.
Obesity consequently distresses the inside of one’s body. Organs, nervous system, hormones and growth can all be severely affected by being overweight. First, obesity influences the brain. Obese people are predisposed to pseudotumor cerebri, which is when pressure inside the skull increased. The brain is affected in a way that the condition appears to be but it is not a tumor. To identify pseudotumor cerebri, doctors look for the existence of swollen optic nerves called papilledema when they examine
The proportion of overweight children (six to eleven years old) climbed from twenty percent in the period from 1976 to 1980 to twenty-seven percent between 1988 and 1994. Approximately five million children and adolescents are now classified as obese. Obesity is a complex disorder involving an excessive amount of body fat. These statistics are proof every year the rate of obesity is increasing, making obesity one of the most common diseases in childhood. Today, many children are too focused on technology