Slipped Capital Femoral Epiphysis and Legg-Calve-Perthes Disease in Adolescents

Some childhood hip diseases can cause problems in the teenage years. This is true of both slipped capital femoral epiphysis (SCFE) and Legg-Calvé-Perthes disease (Perthes).

Both conditions affect the ball and socket of the hip. They can cause pain and loss of mobility as someone heads into adulthood.

But there's hope at the Adolescent and Young Adult (AYA) Hip Preservation Program at UPMC Children's Hospital of Pittsburgh. We specialize in surgeries that correct deformities caused by SCFE and Perthes.

Contact the AYA Hip Preservation Program

Call 412-692-5530 to make an appointment with one of our hip disease experts.

How Do SCFE and Perthes Cause Problems in Adolescents?

SCFE problems

With SCFE, the femoral head (the "ball" part of the thigh bone) slips off of the femoral neck. Though pediatric orthopaedic surgeons can fix the femoral head with a screw, it often leaves children with hip impingement (loss of motion) which can cause pain. This impingement results from a complex deformity of the upper thigh bone. Surgeons typically can’t correct it until you're fully grown.

Perthes disease problems

With Perthes disease, the femoral head loses its blood supply. Without adequate blood supply, the bone softens and collapses. While the bone eventually hardens after a return of blood flow, it has often lost its ideal round shape.

A misshapen hip joint can cause pain and issues with mobility as children move into their teenage years. Once you're fully grown, surgeons can correct the hip joint with:

  • Hip arthroscopy.
  • Surgical dislocation.
  • Other advanced techniques.

Why choose the AYA Hip Preservation Program to treat hip deformities from SCFE and Perthes disease?

  • We bring unmatched expertise to treating hip disorders and injuries in the Pittsburgh region.
  • Michael McClincy, MD, is one of few surgeons in the region who does advanced surgeries on adolescents with SCFE and Perthes disease.
  • We take a team approach in caring for teens and young adults with SCFE and Perthes disease.
  • Our hip disorder research and clinical trials mean you have early access to new and advanced treatments for SCFE and Perthes disease.

SCFE and Perthes Disease Symptoms and Diagnosis

Both conditions are childhood hip diseases.

Most young people who come to the AYA Hip Preservation Program have been living with a diagnosis for years.

Teens and young adults who may have had prior treatment for SCFE or Perthes may suffer symptoms such as:

  • Stiffness and loss of range of motion in the hip joint.
  • Groin and hip pain.
  • Loss of muscle in the upper leg.

In time, these symptoms can affect quality of life. This is why many young adults who have stopped growing seek a more permanent treatment for their hip condition.

Diagnosing problems related to SCFE and Perthes disease

First, we take a medical history and do a physical exam.

The doctor will also ask you to do various range-of-motion tests to see how your hips move.

Our goal is to find out your degree of hip deformity and how it's impacting your life.

To better plan for treatment, we'll x-ray your hip joint.

Advanced imaging tests we use to see the degree of hip joint damage include:

  • CT scan for a 3D view of your hip joint.
  • MRI to see the soft tissue of your hip joint and spot cartilage damage.

At the AYA Hip Preservation Program, we have expert training in interpreting these imaging studies. That matters for helping to figure out the correct course of treatment for your SCFE or Perthes.

SCFE and Perthes Disease Treatments for Adolescents

At the AYA Hip Preservation Program, our goal is to help you enjoy a pain-free life. As a teen or young adult, treating these conditions often requires surgery.

Surgery to correct hip deformities from SCFE and Perthes disease

We tailor our surgical options for each young person we see.

Some issues we'll talk with you about include:

  • Degree of damage. Teenagers come to us with various degrees of hip deformity. Some cases are complex and need the most advanced surgery. We'll walk you through all the options.
  • Timing. You'll need time to heal after surgery, so it's vital to plan accordingly. Is this the right time for you to have surgery?
  • Your goals. What activities is your pain keeping you from doing? What do you want to return to doing? We'll talk with you about your lifestyle and your vision for the future.

The three main types of surgeries we do to correct problems from Perthes disease and SCFE are:

  • Hip arthroscopy. This minimally invasive surgery only needs small incisions — which means a quicker recovery. The surgeon uses a small camera (an arthroscope) to look inside your hip joint. We can repair cartilage or shave off excess bone.
  • Periacetabular osteotomy (PAO). This surgery treats the hip dysplasia that can happen as a result of childhood hip diseases. Hip dysplasia means the ball and socket of the hip joint don't fit together correctly. This surgery helps reposition the ball in the socket (the acetabulum).
  • Dislocation. In this complex surgery, we carefully take the hip out of the socket. Then, we can reshape or reconstruct the hip joint. UPMC surgeons have specialized skill and knowledge in this surgery.

Physical therapy and post-op rehab

Our on-site physical therapist, Ashley DiSantis, DPT, OCS, is integral to your care team. She's with you both before and after surgery to help you make a full recovery.

Contact the AYA Hip Preservation Program

To make an appointment for SCFE or Perthes disease, call 412-692-5530.