Acute Necrosis of Cartilage in Slipped Capital Femoral Epiphysis

A series of twenty-eight patients (thirty-nine hips) with slipped capital femoral epiphysis has been presented. In eleven hips in eleven patients acute necrosis of cartilage developed. The incidence of acute necrosis of cartilage complicating slipped femoral epiphysis in patients of Hawaiian ancestry appears quite high. Whether this is due to genetic or socioenvironmental factors has not been determined. The incidence of acute necrosis of cartilage is most directly correlated with the severity of the femoral epiphyseal slipping at the time of diagnosis. Slipped capital femoral epiphyses treated by open reduction, cast immobilization, or prolonged traction appeared to be most susceptible to acute necrosis of cartilage. However, any conclusion that there is a necessary relationship may be an illusion, since it was the most severe slippings that had this kind of treatment. Acute necrosis of cartilage is a severe complication of slipped capital femoral epiphysis. Although occasionally some cartilage space is reconstituted, the usual course is eventual ankylosis or progressive degenerative arthritis of the involved hip.