SUFE or Slipped Upper Femoral Epiphysis is a childhood condition where there is a fracture through the growth plate of the femoral head. This occurs in early adolescence and usually presents with pain in the groin and occasionally on the front of the knee.
Figure 2: X-Ray showing a left sided SUFE
If this condition is detected early, before there is a significant slip, it can be pinned using a screw. While there is a small risk of post-operative complications such as infection and avascular necrosis, most patients will do well without the need for future surgery. If the slip is severe or detected late, it can heal in an abnormal position. Unlike other childhood conditions such as Perthes disease, there is no time for the socket to remodel, so there is a miss-match between the socket and the head.
This miss-match can lead to significant degeneration, even in early adulthood. Even significant deformities may be treatable with conservative types of surgery such as open hip debridement or hip arthroscopy where the head is reshaped, but once the degeneration progresses and there is a loss of joint space, then the only remaining option is a joint replacement.
As in other conditions, this can be demanding surgery. The hip can be quite scarred and the abnormal anatomy not amenable to standard implants. However, with meticulous technique, restoration of anatomy can be achieved with excellent functional result.