slipped capital femoral epiphysis slipped upper femoral epiphysis
Conditions
Interventions
Walkin on the CAREN system can be seen as an intervention, since children
should walk on this specific treadmill.
Sponsors
Medisch Universitair Ziekenhuis Maastricht
Eligibility
Age
2 Years to 99 Years
Inclusion criteria
Inclusion criteria: * Age between 8 and 21 years. * Unilateral stable SCFE, with clinical and radiological confirmation and lateral slip angles ranging from mild (LSA 50°) based on the method of Southwick. * Treatment of the slip with single screw in situ fixation in the last ten years, with no evidence of major complications related to the procedure like chondrolysis, avascular necrosis and infection or slip progression. * Follow up at our institution for at least one year. * Ability to walk 30 minutes without aid. * Able to speak, understand and read the Dutch language.
Exclusion criteria
Exclusion criteria: * Clinical or radiological evidence of a contralateral slip or an endocrinopathy as underlying cause of SCFE. * Revision surgery. * Other pathology leading to gait alterations.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Kinematic data at pelvis, hip, knee and ankle level will be gained by using the CAREN system. Multiple consecutive steps will be evaluated. These kinematic data will also be used to evaluate the margins of stability, which is an adequate manner to analyse dynamic postural balance. These parameters enables us to answer our primary research questions: 1.Is protraction of the pelvis at the affected side a compensatory mechanism to reduce out-toeing and thereby improve foot positioning during gait in patients with unilateral stable SCFE, treated with single screw in situ fixation? a. Are patients with treated SCFE less able to use this compensatory mechanism when walking/running at a higher speed? 2. Are the structural changes in the hip joint in SCFE resulting in an impaired dynamic postural balance during normal gait and walking/running at a fixed speed? 3. What is the effect of stable SCFE, treated with single screw in situ fixation, on muscle activation patterns in the lower extremity and are there difference with healthy controls? | — |
Secondary
| Measure | Time frame |
|---|---|
| Secondary study parameters are muscle activation patterns gained by surface EMG during the gait analysis. The Harris Hip Score and the Borg score will be recorded to evaluate the clinical outcome. These parameters enables us to answer the following secondary research questions: 1. To what degree are kinematic parameters at pelvis, hip, knee and ankle level deviating in patients with unilateral stable SCFE, managed with single screw in situ fixation, compared with the sound side and children adolescents with no gait pathology? 2. What is the clinical outcome of patients with unilateral stable SCFE, treated with single screw in situ fixation, based on the Hip Injury and Osteoarthritis Outcome Score and SF-36 and is this score correlated to the degree of initial slip? 3. Is there a difference in the severity of tiredness between SCFE patients, treated with single screw in situ fixation, and healthy controls directly after the gait analysis based on the Borg CR10 score and is this score correlated to the degree of initial slip? | — |
Countries
Netherlands
Outcome results
None listed