Chondrolysis of the hip complicating slipped capital femoral epiphysis: Long-term follow-up of nine patients

Nine patients with chondrolysis secondary to slipped capital femoral epiphy sis of the hip were followed up from a minimum of 7 to a maximum of 19 year s (average, 13.7 years) after the onset of the disease. The degree of slipp ing of the proximal epiphysis of the femur was severe in five patients and moderately severe in four patients. The nine patients were treated with non -weight bearing, antiinflammatory drugs, and physical therapy. The disease had a good resolution, with gradual regression of pain, and radiographs sho wed restoration of the joint space in an average of 10 months. At follow-up , mild coxalgia after prolonged activity was present in five patients, wher eas in the one patient with concomitant avascular necrosis, pain was much m ore intense. All patients had some limitation of range of motion of the hip . It was most restricted in two patients, one with associated avascular nec rosis and one with a severe slip. In all patients, radiographs showed resto ration of the joint space. In the group with severe degrees of slipping, th ere were marginal osteophytes of the femoral head and the acetabulum. Signi ficant arthrosis was present in the patient treated conservatively and in t he patient with associated ischemic necrosis. In this long-term study of ch ondrolysis secondary to slipped capital femoral epiphysis, the overall prog nosis was benign and was determined by the degree of slipping of the proxim al epiphysis of the femur and concomitant aseptic necrosis. However, the au thors believe that the patients with radiographic signs of degenerative joi nt disease may have a poor long-term prognosis.