The John Charnley Award Paper. Experimental epiphysiolysis: etiologic models slipped capital femoral epiphysis.

The several anatomic features that permit the growth plate to resist shear forces were identified. Specific variations in these anatomic features were correlated with pathologic factors known to be associated with epiphysiolysis, including clinical correlations with slipped capital femoral epiphysis. Two models of epiphysiolysis representing different pathogenetic pathways were established in the pig and compared to clinical slipped capital femoral epiphysis in the human. Both experimental models and other models reported in the literature bear similarities mechanically and histologically to the human disease. Available evidence suggests that slipped capital femoral epiphysis may not be a single disease but a final mechanical event that occurs as a result of a variety of disease processes. These disease processes reduce by different mechanisms the ability of the growth plate to resist shear forces.