Our 13-year old son is quite overweight and has developed a hip problem from obesity. It’s called slipped capital femoral epiphysis. So far, it’s only on the left. Can it develop on the right? What can we do to prevent this from happening?

Slipped capital femoral epiphysis (SCFE) is a fairly common hip problem. It affects teenagers between the ages of 12 and 16. In this condition, the growth center of the hip (the capital femoral epiphysis) actually slips backwards on the top of the femur (the thighbone).

Obesity is the biggest risk factor for SCFE because of the increased shear across the top of the femur from the extra weight on bone that hasn’t fully developed. Hormonal changes, rapid, growth, and endocrine factors may also play a role in SCFE.

The condition affects both hips in 50 to 60 per cent of all cases. Your physician will examine both hips and advise you. If there are signs of early changes in the other hip, then treatment of both hips may be needed. Studies show most children who have bilateral SCFE will develop a second slip within 18 months of the first one.

Treatment is most often with a long screw into the epiphysis to hold it in place. This can be done on both sides at the same time if needed. The surgeon will take into consideration your son’s age, endocrine status, X-ray findings, and your preferences when making this decision.

Research shows that screw fixation of the unaffected side is helpful. Unfortunately there’s no way to predict who needs this kind of preventive care or if it will always work.