{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T14:26:34Z","timestamp":1786112794058,"version":"build-2736575974"},"reference-count":34,"publisher":"MJS Publishing, Medical Journals Sweden AB","license":[{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ActaO"],"abstract":"<jats:p>Background and purpose:\u00a0Optimal treatment for slipped capital femoral epiphysis (SCFE) has been controversial for decades. Capital realignment surgery (predominant technique: modified Dunn) is a technique to restore anatomy, but it is associated with varying risks of avascular necrosis (AVN) of the femoral head. The aim of our study was to describe outcomes following capital realignment for severe SCFE in a nationwide cohort.Methods:\u00a0A longitudinal, nationwide, retrospective cohort study of SCFE patients treated with capital realignment between 2009 and 2021 was conducted, with radiographic and clinical follow-up 2\u201315 years after surgery. Primary radiographic outcome was AVN. Clinical outcomes were assessed using patient-reported outcome measures (the Copenhagen Hip and Groin Outcome Score [HAGOS] and the 12-item International Hip Outcome Tool [iHOT12]).Results:\u00a028 patients were included but 1 patient declined radiographic follow-up. 6\/27 (22%, 95% confidence interval [CI] 11\u201341), developed AVN: 2\/19 patients with stable SCFE and 4\/8 patients with unstable SCFE. None of the 8 cases in which epiphyseal perfusion was monitored intraoperatively developed AVN. The median total HAGOS and iHOT12 scores were 77 (CI 56\u201394) and 76 (CI 72\u201388), respectively. When capital realignment was performed as primary treatment (&lt; 1 month from diagnosis), the corresponding scores were 91 (CI 70\u201398) and 88 (CI 73\u201398).Conclusion:\u00a0The overall AVN rate was 22%. Our findings suggest that capital realignment should be reserved for stable SCFE and performed as primary treatment, with intraoperative epiphyseal perfusion monitoring.<\/jats:p>","DOI":"10.2340\/17453674.2026.46429","type":"journal-article","created":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T15:54:22Z","timestamp":1785945262000},"source":"Crossref","is-referenced-by-count":0,"title":["The Swedish experience of capital realignment surgery for slipped capital femoral epiphysis: results from a nationwide retrospective cohort of 28 patients"],"prefix":"10.2340","volume":"97","author":[{"given":"Jens","family":"Nilsson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikael","family":"Lindell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jakob","family":"\u00d6rtegren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4311-3860","authenticated-orcid":false,"given":"Bengt","family":"Herngren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaretha","family":"Stenmarker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5707-4893","authenticated-orcid":false,"given":"Piotr","family":"Michno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7717-1578","authenticated-orcid":false,"given":"Carl Johan","family":"Tiderius","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1183","published-online":{"date-parts":[[2026,8,5]]},"reference":[{"key":"164884","doi-asserted-by":"crossref","unstructured":"Naseem H, Chatterji S, Tsang K, Hakimi M, Chytas A, Alshryda S. Treatment of stable slipped capital femoral epiphysis: systematic review and exploratory patient level analysis. J Orthop Traumatol 2017; 18(4): 379-94. doi: 10.1007\/s10195-017-0469-4.","DOI":"10.1007\/s10195-017-0469-4"},{"key":"164885","doi-asserted-by":"crossref","unstructured":"de Poorter J J, Beunder T J, Gareb B, Oostenbroek H J, Bessems G H, van der Lugt J C, et al. Long-term outcomes of slipped capital femoral epiphysis treated with in situ pinning. J Child Orthop 2016; 10(5): 371-9. doi: 10.1007\/s11832-016-0759-z.","DOI":"10.1007\/s11832-016-0759-z"},{"key":"164886","doi-asserted-by":"crossref","unstructured":"Leunig M, Slongo T, Kleinschmidt M, Ganz R. Subcapital correction osteotomy in slipped capital femoral epiphysis by means of surgical hip dislocation. Oper Orthop Traumatol 2007; 19(4): 389-410. doi: 10.1007\/s00064-007-1213-7.","DOI":"10.1007\/s00064-007-1213-7"},{"key":"164887","doi-asserted-by":"crossref","unstructured":"Ziebarth K, Zilkens C, Spencer S, Leunig M, Ganz R, Kim Y-J. Capital realignment for moderate and severe SCFE using a modified Dunn procedure. Clin Orthop Rel Res 2009; 467(3): 704-16. doi: 10.1007\/s11999-008-0687-4.","DOI":"10.1007\/s11999-008-0687-4"},{"key":"164888","doi-asserted-by":"crossref","unstructured":"Tannast M, Jost L M, Lerch T D, Schmaranzer F, Ziebarth K, Siebenrock K A. The modified Dunn procedure for slipped capital femoral epiphysis: the Bernese experience. J Child Orthop 2017; 11(2): 138-46. doi: 10.1302\/1863-2548-11-170046.","DOI":"10.1302\/1863-2548-11-170046"},{"key":"164889","doi-asserted-by":"crossref","unstructured":"Masquijo J J, Allende V, D\u2019Elia M, Miranda G, Fern\u00e1ndez C A. Treatment of slipped capital femoral epiphysis with the modified Dunn procedure: a multicenter study. J Pediatr Orthop 2019; 39(2): 71-5. doi: 10.1097\/bpo.0000000000000936.","DOI":"10.1097\/BPO.0000000000000936"},{"key":"164890","doi-asserted-by":"crossref","unstructured":"Alves C, Steele M, Narayanan U, Howard A, Alman B, Wright J G. Open reduction and internal fixation of unstable slipped capital femoral epiphysis by means of surgical dislocation does not decrease the rate of avascular necrosis: a preliminary study. J Child Orthop 2012; 6(4): 277-83. doi: 10.1007\/s11832-012-0423-1.","DOI":"10.1007\/s11832-012-0423-1"},{"key":"164891","unstructured":"Beslutsst\u00f6d f\u00f6r h\u00f6ftfyseolys, SBOF Svensk BarnOrtopedisk F\u00f6rening [in Swedish]. 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