Slipped capital femoral epiphysis after tumor prosthesis implantation in a patient receiving chemotherapy

Recep Öztürk; Markus Nottrott; Wiebke Guder; Julian Röder; Christina Polan; Lars Erik Podleska; Arne Streitbürger; Jendrik Hardes; Nina Myline Engel

doi:10.52312/jdrs.2024.1493

Recep Öztürk¹, Markus Nottrott¹, Wiebke Guder¹, Julian Röder¹, Christina Polan², Lars Erik Podleska¹, Arne Streitbürger¹, Jendrik Hardes¹, Nina Myline Engel¹

¹Department of Orthopedic Oncology, University Hospital Essen, Essen, Germany
²Department of Trauma Surgery, University Hospital Essen, Essen, Germany

Keywords: Chemotherapy, hip disorders, slippage, slipped capital femoral epiphysis, tumor prosthesis.

Abstract

While the usual etiology of slipped capital femoral epiphysis (SCFE) is idiopathic, there are many other factors that increase the predisposition to slippage. Chemotherapy can be one of them. In this article, we report a rare case of acute SCFE after tumor prosthesis implantation in a patient who received chemotherapy. A 10-year-old girl with osteosarcoma of the right distal femur underwent (neo-) adjuvant chemotherapy, wide tumor resection, and reconstruction using a growing tumor prosthesis and a short non-cemented femoral stem. Half a year after implantation, she developed aseptic loosening. Revision surgery was performed using a hydroxyapatite (HA)-coated cementless femoral stem. Postoperative plain radiographs revealed SCFE that was treated by closed reduction and screw fixation. The patient recovered without complications, and unaffected hip showed no radiographic signs of slippage on follow-up. The forces of implanting a tumor prosthesis, particularly with a non-cemented stem, can increase the risk of an acute SCFE. The controversy over prophylactic pinning of the uninvolved hip in chemotherapy-associated SCFE is unresolved. Pinning can be considered only in the presence of abnormal prodromal radiological findings.

Citation: Öztürk R, Nottrott M, Guder W, Röder J, Polan C, Podleska LE, et al. Slipped capital femoral epiphysis after tumor prosthesis implantation in a patient receiving chemotherapy. Jt Dis Relat Surg 2024;35(2):443-447. doi: 10.52312/jdrs.2024.1493.

Informed Consent

A written informed consent was obtained from the parent of the patient.

Author Contributions

Idea/concept: A.S., J.H., M.N., N.M.E.; Control/supervision: L.E.P., W.G.; Data collection and/ or processing: C.P., J.R.; Literature review, writing the article: R.Ö., M.N.; Critical review: A.S., J.H.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.

Data Sharing Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.