What question did this study set out to answer?

This study aims to assess the relationship between obesity and postoperative complications in children treated for SCFE.

March 23, 2026Journal of the Pediatric Orthopaedic Society of North America0 citationsOpen Access

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Original Research: Impact of Obesity on Complication Rates after Treatment of Slipped Capital Femoral Epiphysis: A Retrospective Cohort Database Study

HAHolden Archer SRScott B. Rosenfeld PCPablo Castañeda

Key Points

This study aims to assess the relationship between obesity and postoperative complications in children treated for SCFE.
Queried a national database for pediatric patients treated for SCFE from June 2005 to June 2025.
Divided patients into obesity and non-obesity groups.
Matched cohorts using a propensity scoring algorithm on a one-to-one basis.
Tracked postoperative outcomes including infection, pulmonary embolism, chondrolysis, avascular necrosis, leg length discrepancy, and hardware complications.
Employed Relative Risk Ratio and 95% confidence intervals for statistical analysis.
Infection rates were low (<1%) and did not differ significantly between groups.
Avascular necrosis rates were similar: 38 (3.23%) in obesity vs 34 (2.89%) in non-obesity (RR=1.12).
Leg length discrepancy occurred in 77 (6.55%) obese vs 50 (4.26%) non-obese patients (RR=1.54).
Hardware complications were experienced by 61 (5.19%) obese vs 35 (2.98%) non-obese patients (RR=1.74).

Abstract

While obesity is a well-established risk factor for slipped capital femoral epiphysis (SCFE), limited data exist regarding its impact on postoperative complication rates. This study aimed to evaluate the association between obesity and complications following SCFE treatment. We queried a large national database for pediatric patients who underwent treatment for SCFE between June 2005 and June 2025. We divided this cohort into patients with obesity and patients without obesity. We matched the cohorts with a propensity scoring algorithm on a one-to-one basis resulting in 1,175 patients in each group. We tracked outcomes including infection, pulmonary embolism (PE), chondrolysis, avascular necrosis (AVN), leg length discrepancy (LLD), and hardware complications. We employed the Relative Risk Ratio (RR) and 95% confidence intervals (CI). P-values less than 0.05 were considered significant. ≤10 (0.85%) patients developed an infection and none developed a PE. ≤10 (0.85%) patients in each group developed chondrolysis. 38 (3.23%) patients in the obese group developed AVN after SCFE treatment, and 34 (2.89%) patients in the non-obese group developed AVN (RR=1.12, CI 0.71-1.76, p=0.632). 77 (6.55%) patients in the obese group developed LLD compared to 50 (4.26%) patients in the non-obese group (RR=1.54, CI 1.09-2.18, p=0.014). 61 (5.19%) patients in the obese group had hardware complications, whereas 35 (2.98%) patients in the non-obese group did (RR=1.74, CI 1.16-2.62, p=0.007). Patients with obesity had increased rates of LLD and hardware complications after treatment for SCFE compared to non-obese patients. Our findings highlight the importance of ongoing follow-up and monitoring of SCFE patients to detect the development of any of these outcomes. Level III: Retrospective cohort study. • Rates of infection, pulmonary embolism, and chondrolysis were low (<1%) and did not differ between obese and non-obese cohorts. • The rate of avascular necrosis was similar between groups. • In contrast, obese patients had significantly higher rates of leg length discrepancy and hardware complications.

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Cite This Study

Archer et al. (Sun,) studied this question.

synapsesocial.com/papers/69c0de74fddb9876e79c137c https://doi.org/https://doi.org/10.1016/j.jposna.2026.100370

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