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Our 12-year-old was just diagnosed with mild SCFE. We've been told there could be complications. What can we expect to happen with this condition?

SCFE stands for slipped capital femoral epiphysis. It is a condition in which the growth center of the hip (the capital femoral epiphysis) has slipped backwards on the top of the femur (the thighbone).

Treatment is usually surgical to pin the bones in place. The pin is left in place permanently or in some cases, until the child has reached growth maturity. This is an important step to stop any further slippage of the epiphysis. The less slip, the lower the risk of problems in the hip during the child's life.

Avascular femoral necrosis is a concern with SCFE. This refers to a loss of blood to the head of the femur. Without enough blood and oxygen, the bone cells can start to die. If the condition progresses far enough, the head of the femur collapses.

Chondrolysis is another potential complication. The articular cartilage of the joint starts to break down and dissolve. The joint space narrows and there's an increase in stiffness of the hip joint. Both necrosis and chondrolysis can lead to early degenerative arthritis.

Early intervention can help prevent some of these problems from happening. The surgeon will watch the other hip carefully for any signs of developing SCFE. Some experts advise pinning the capital femoral epiphysis in the uninvolved hip to keep it from slipping later. There is much debate about whether or not this step is needed.

A recent study from Children's Hospital of Philadelphia (CHOP) strongly supports the use of preventive (prophylactic) pinning. The risk and rate of a second slip are both high enough to warrant this type of treatment. The pin can be inserted in the unaffected hip at the same time surgery is done on the first hip.

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