Disabling hip disease is another health risk for obese children

By Serena Gordon
HealthDay Reporter

MONDAY, Oct. 22, 2018 (HealthDay News) – Childhood obesity is associated with a higher risk of type 2 diabetes and early heart disease, but new research now links it to an illness hip, sometimes disabling.

This is called the capital slip femoral epiphysis (ECHF), and this causes the deformity of the hip, sometimes to such an extent that the hip sinks. SCFE causes pain and can lead to permanent disability, say British researchers.

"Children with severe obesity at the age of 5 were nearly 20 times more likely to develop severe hip deformity than a lean child," said Dr. Daniel Perry , author of the study, Lecturer in Orthopedic Surgery at the University of Liverpool.

The more heavy a child was, the greater the risk of hip disease, said Perry.

SCFE occurs when the epiphysis – the head of the femur – slides from the bone to the growth plateau, according to the American Academy of Orthopedic Surgeons. Growth plates are weaker bone areas that are not yet fully developed.

So, how does being overweight pose this problem?

"The belief is that it's a mechanical failure," Perry said. "Simply, the supporting structures around the growth plate in the hip can not support the weight of the child.The growth plate slips so out of place – it is sometimes a problem. a sudden process, or sometimes it happens very gradually. "

Dr. Matthew Hepinstall, associate director of the Center for Joint Preservation and Reconstruction at Lenox Hill Hospital in New York, said that SCFE is more common in preadolescents and young adolescents.

"This appears to occur most often during growth spurts, when growth plates are wider and therefore weaker.It is not diagnosed early and stabilized by surgery, parts of the femur on each side of the displacement of the growth plateau, "he explained.

Hepinstall added that although this injury can heal, the bone develops with an abnormal shape that can cause hip problems in adulthood.

He added that the problem is more common in heavier children because "weight puts more stress on the growth plate".

Perry said the disease still needed to be treated surgically to stabilize the hip. If the problem is diagnosed early, the surgery is minor.

If it is diagnosed that when the hip is severely displaced, "the child may have to undergo a high-risk surgery to rebuild the hip. [our] Wherever possible, the hip bone often dies when the supply of blood that feeds the hip is injured, whether through disease or reconstructive surgery, "he said.

When the hip bone dies, hip replacement may be the only alternative. "It's a huge undertaking for a young person, and we expect many repeat surgeries to be needed throughout their lives," said Perry.

In this study, researchers analyzed the health information of nearly 600,000 Scottish children in two different studies. One study included children aged 5 and 6 born in 1970. The other study started in 1995.

All children took measures of height and weight when they started elementary school and again between 11 and 12 years old.

According to the study, 75% of obese youth at age 5 or 6 were still obese at the age of 11 or 12 years old.

Severely obese children at the age of 5 or 6 were almost six times more likely to have SCFE than their normal-weight counterparts. Those who were severely obese at age 11 or 12 were 17 times more likely to develop hip disease. And the more a child gains weight, the higher the risk of FPCS.

"We are very worried that there is an explosion of this hip disease if childhood obesity continues to increase," Perry said.

He said that it is important that parents realize that children will not only become too big for obesity. Important lifestyle changes are needed.

However, given the increase in obesity in children, Perry also pointed out that doctors who care for children need to be aware of this disease.

"Pain in the hip – and knee pain because the hip and knee share sensitivities [feeling] Nerves – in adolescents, and especially in obese adolescents, can mean that the child has SCFE, "said Perry. Children with hip pain should be urgently examined, as well as x-rays to identify deformity.

The results were published online on October 22 in the journal pediatrics.

More information

The American Academy of Orthopedic Surgeons has more details on the capital femoral epiphysis.

SOURCES: Daniel Perry, MB, Ch.B., Ph.D., FRCS, Clinical Scientist at the National Institute of Health Research, Consultant in Children's Orthopedic Surgery, Alder Hey Children's Hospital, Liverpool, and Master Clinical Lectures at the University of Liverpool, and Associate Professor at the University of Oxford, England; Matthew Hepinstall, M.D., Associate Director, Center for Joint Preservation and Reconstruction, Lenox Hill Hospital, New York; October 22, 2018, pediatrics