My grandson has a mild case of slipped capital femoral epiphysis. His parents want to adopt a wait-and-see approach rather than have him go through surgery. We're concerned that waiting too long could make the problem even worse. What do you advise?

Slipped capital femoral epiphysis (SCFE) is a fairly common hip disorder. It affects the hip in teenagers between the ages of 12 and 16. Treatment of SCFE usually requires surgery.

The main goal of the treatment is to stop any further slippage of the capital femoral epiphysis. The epiphysis is the growth plate at the top of the femur (thigh bone). The less slip, the lower the risk of problems in the hip during the child's life. Surgery usually speeds up the process of epiphysis closure.

For the child, pain relief and restoring hip function are the immediate benefits of surgery. Long-term results of treatment include preserving the joint and preventing degeneration and arthritis.

Studies show that even mild SCFE can cause changes in the shape of the joint. Arthritis can develop later on. Unless the surgeon agrees that a wait-and-see approach is acceptable, immediate surgery is the accepted standard of care. This recommendation is supported by many long-term studies showing the safety and functional outcomes of treatment.