Controversy remains whether the contralateral
hip should be fixed in patients presenting with unilateral slipped capital
femoral epiphysis (SCFE). This retrospective study compares the
outcomes and cost of those patients who had prophylactic fixation
with those who did not. Between January 2000 and December 2010 a total of 50 patients
underwent unilateral fixation and 36 had prophylactic fixation of
the contralateral hip. There were 54 males and 32 females with a
mean age of 12.3 years (9 to 16). The rate of a subsequent slip
without prophylactic fixation was 46%. The risk of complications
was greater, the generic health measures (Short Form-12 physical
(p <
0.001) and mental (p = 0.004) summary scores) were worse.
Radiographic cam lesions in patients presenting with unilateral
SCFE were only seen in patients who did not have prophylactic fixation.
Furthermore, prophylactic fixation of the contralateral hip was
found to be a cost-effective procedure, with a cost per quality
adjusted life year gained of £1431 at the time of last follow-up. Prophylactic fixation of the contralateral hip is a cost-effective
operation that limits the morbidity from the complications of a
further slip, and the diminished functional outcome associated with
unilateral fixation. Cite this article:
