Hip: Original ArticleIncreased Intracapsular Pressures After Unstable Slipped Capital Femoral EpiphysisHerrera-Soto, Jose A. MD*; Duffy, Michael F. MD*; Birnbaum, Mark A. MD*; Vander Have, Kelly L.†Author Information From the *Orlando Regional Medical Center, Orlando, FL; and †University of Michigan, Ann Arbor, MI. Reprints: Jose Antonio Herrera-Soto, MD, 83 W. Columbia St, Orlando, FL 32806. E-mail: [email protected]. Journal of Pediatric Orthopaedics: October/October-November 2008 - Volume 28 - Issue 7 - p 723-728 doi: 10.1097/BPO.0b013e318186bda3 Buy Metrics Abstract Background: Osteonecrosis of the femoral head is the most dreaded complication associated with an unstable slipped capital femoral epiphysis (SCFE). We hypothesize that the hip joint pressure will be increased in unstable slips, confirming that emergent treatment and decompression are warranted. Methods: Thirteen unstable SCFE hips were evaluated. Hip pressure monitoring was performed. Postcapsulotomy measurements were also performed in all of the patients. Five of these under gentle manipulation. Six patients underwent measurement of the hip pressure on the unaffected side. Results: The mean pressure on the affected hip was 48 mm Hg. The mean pressure on the unaffected side was 23 mm Hg. There was a significant increase in intraarticular hip pressure after attempted manipulation (mean, 75 mm Hg). Discussion: Hip pressures are increased in unstable SCFE to levels higher for those of a compartment syndrome probably causing a tamponade effect. There is a need to perform a capsulotomy if manipulation is performed. © 2008 Lippincott Williams & Wilkins, Inc.