Before the routine intraoperative use of fluoroscopy at our institution
during procedures to stabilize a slipped capital femoral epiphysis,
twenty-five patients (thirty hips) had in situ cannulated-screw
stabilization of a slipped capital femoral epiphysis with use of biplane
radiography. Thus, a permanent record of the procedure was available for
review. Fourteen hips in fourteen patients had an intraoperative episode
during which the joint was penetrated by the guide-pin assembly or
cannulated screw, or both. This penetration was corrected at the time of
the operation. Eleven patients were followed for a minimum of two years
(mean, thirty-nine months; range, twenty-four to sixty-three months). All
physes went on to closure. None of the patients had clinical or
radiographic evidence of chondrolysis. Transient penetration of the hip
joint did not lead to chondrolysis in this series. This suggests that a
single episode of penetration by a pin or screw, with immediate removal
from the joint, is not associated with the development of chondrolysis.