# Bilateral Total Hip Replacement for Slipped Capital Femoral Epiphysis in a Young Adult After Growth Hormone Therapy: A Case Report

## TL;DR

A 26-year-old man with a history of growth hormone therapy developed severe hip issues and was successfully treated with a two-stage hip replacement.

## Contribution

This case report highlights bilateral total hip replacement as a viable treatment for severe slipped capital femoral epiphysis in young adults.

## Key findings

- Bilateral total hip replacement was successfully performed in a young adult with severe slipped capital femoral epiphysis.
- The case emphasizes the importance of monitoring patients on growth hormone therapy for potential complications like SCFE.
- Multidisciplinary care involving endocrinology, neurosurgery, and orthopedics was crucial for managing the patient's complex condition.

## Abstract

We present the case of a 26-year-old male who developed bilateral slipped capital femoral epiphysis (SCFE) as a complication of recombinant human growth hormone (rhGH) therapy and was treated with a two-stage bilateral total hip replacement (THR). Growth hormone deficiency was due to a craniopharyngioma, for which curative neurosurgical excision led to panhypopituitarism requiring lifelong hormone replacement and continuation of rhGH therapy. The patient reported bilateral groin pain for two years before presentation; symptoms were initially attributed to short stature and spinal issues, resulting in delayed diagnosis. On presentation, there were clear signs of severe bilateral SCFE, confirmed by radiographs and CT. After shared decision-making, the patient underwent staged bilateral THR, beginning with the left hip. The case illustrates that, with advances in surgical technique and prosthetic materials, THR can be a viable option for young adults with severe SCFE, even when bilateral. It underscores the need for vigilance in monitoring patients on rhGH, particularly those with hypopituitarism, for SCFE, and highlights the importance of multidisciplinary care across endocrinology, neurosurgery, and orthopedic management.