Obe­sity a risk for hip dis­ease

Helen O’Cal­laghan finds some teens face life­long dis­abil­ity

Irish Examiner - Feelgood - - Parenting -

CHILD­HOOD obe­sity is a ma­jor risk fac­tor for se­ri­ous hip dis­ease, ac­cord­ing to new re­search, which sug­gests ris­ing child­hood obe­sity rates are caus­ing more ado­les­cents to de­velop a de­bil­i­tat­ing hip con­di­tion re­quir­ing ur­gent surgery.

Slipped cap­i­tal femoral epi­ph­ysis (SCFE) oc­curs among teens, af­fect­ing one in 2,000 chil­dren. The hip de­forms, some­times com­pletely col­laps­ing, caus­ing pain and life­long dis­abil­ity. Sur­geons long sus­pected obe­sity was the cause, but there was no sub­stan­tial proof un­til the cur­rent study, con­ducted by re­searchers from uni­ver­si­ties of Liver­pool, Ox­ford, and Aberdeen, as well as Alder Hey Chil­dren’s Hos­pi­tal.

The re­searchers looked at body mass in­dex (BMI) for nearly 600,000 chil­dren in Scot­land. They found obese five-year-olds had a 75% like­li­hood of re­main­ing obese by the time they were 12. Most cru­cially, chil­dren with se­vere obe­sity as five-year-olds had al­most 20 times the sub­se­quent risk of de­vel­op­ing SCFE than a thin child. The greater the BMI, the greater the SCFE risk.

The find­ings serve as a warn­ing here in Ire­land. Last year, the Child­hood Obe­sity Surveil­lance Ini­tia­tive re­ported at least one in five chil­dren are over­weight or obese. Daniel Perry, se­nior lec­turer in Or­thopaedic Surgery at Univer­sity of Liver­pool and chil­dren’s or­thopaedic sur­geon at Alder Hey Chil­dren’s Hos­pi­tal, says obe­sity needs to be tack­led right at the start, even be­fore chil­dren are five. “Par­ents say ‘they’ll out­grow it, it’s just puppy fat’. It’s not puppy fat at three or four years old. The fun­da­men­tal way to tackle it is to stop sugar — this is a dis­ease of sugar.” Mr Perry has seen SCFE in chil­dren as young as six years but says it’s com­mon­est from age 10 on.

“The ear­li­est sign is of­ten knee pain — our hips and knees have the same nerve sup­ply. Many GPs will only see SCFE a cou­ple of times in their ca­reer so it’s not at the fore­front of their mind. Even or­thopaedic sur­geons and A&E doc­tors miss it. They x-ray the knee, do MRIs on it, and put in a cam­era — and even­tu­ally find out it’s a hip con­di­tion.”

Catch­ing SCFE early is vi­tal. “Early [iden­ti­fi­ca­tion] means chil­dren typ­i­cally only need rel­a­tively sim­ple surgery.

“[But] chil­dren iden­ti­fied later of­ten re­quire high-risk re­con­struc­tive surgery.”

Steve Turner, pro­fes­sor of Pae­di­atrics at Univer­sity of Aberdeen, says: “SCFE’s link with obe­sity is strik­ing. There are few other dis­eases in chil­dren that oc­cur di­rectly as a con­se­quence of obe­sity, and this dis­ease causes life­long prob­lems.”

Pic­ture: iS­tock

NOT HIP: A study found the higher the child’s BMI, the greater the risk of a de­bil­i­tat­ing hip con­di­tion.

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