Obesity a risk for hip disease
Helen O’Callaghan finds some teens face lifelong disability
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.”
NOT HIP: A study found the higher the child’s BMI, the greater the risk of a debilitating hip condition.