Slipped Capital Femoral Epiphysis Pathogenesis and Its Relation to Obesity—Where Do We Stand? A Narrative Review
and Georgios Katsaras 2,*Round 1
Reviewer 1 Report
The manuscript is interesting, informative and has merit. I have only a few comments:
1. Line 45: A reference 10 should be formatted according to the journal style.
2. Is there any data if obese children with diabetes and without diabetes (or metabolic syndrome) have the same occurrence of SCFE?
3. Lines 164-168, there seems to be citation missing?
4. Line 210: explanation what SUFE means is missing.
5. Figure 2 is very simple, I suggest to extend it and more comprehensively depict the potential pathophysiologic and risk factors and their interactions in SCFE. Keep in mind that most of the readers will look at the figures first.
Author Response
The manuscript is interesting, informative and has merit. I have only a few comments:
Response: We thank the reviewer for his kind comments.
- Line 45: A reference 10 should be formatted according to the journal style.
Response: Reference 10 was formatted according to the journal style.
- Is there any data if obese children with diabetes and without diabetes (or metabolic syndrome) have the same occurrence of SCFE?
Response: To the best of our knowledge there isn’t any study that examines the difference in the occurrence of SCFE in obese children with and without diabetes or metabolic syndrome.
- Lines 164-168, there seems to be citation missing?
Response: We added the proper reference. Witbreuk, M.; van Kemenade, F. J.; van der Sluijs, J. A.; Jansma, E. P.; Rotteveel, J.; van Royen, B. J. Slipped Capital Femoral Epiphysis and Its Association with Endocrine, Metabolic and Chronic Diseases: A Systematic Review of the Literature. J. Child. Orthop. 2013, 7 (3), 213–223. https://doi.org/10.1007/s11832-013-0493-8
- Line 210: explanation what SUFE means is missing.
Response: SUFE means slipped upper femoral epiphysis, but we changed it into SCFE, as this term is used throughout our manuscript.
- Figure 2 is very simple, I suggest to extend it and more comprehensively depict the potential pathophysiologic and risk factors and their interactions in SCFE. Keep in mind that most of the readers will look at the figures first.
Response: We corrected Figure 2.
Reviewer 2 Report
Chatziravdeli_Capital Femoral_surgeries_2023
Thank you for the opportunity to review this manuscript. I congratulate the authors on the completion of this manuscript. Overall it is well written and on an important topic. The reflection is guided by an adequate compilation of facts and literature.
However, I have some comments and suggestions presented below
Title
Please add to the title the type of manuscript: a narrative review.
1. Introduction
Line 45. Please, correct the format of this reference.
2. Epidemiology
Line 60: “up to 4.1:1”, in what population?
Table 2. To what specific timeframe refers the data presented as incidence.
3. Slipped capital femoral epiphysis and obesity
Line 94. “In a case-control study of 51 patients treated for SCFE, mean HbA1c levels were significantly higher than obese patients without the condition, but there were no differences in the lipid profile [35].” Please correct to: “In a case-control study of 51 patients treated for SCFE, mean HbA1c levels were significantly higher than in obese patients without the condition, but there were no differences in the lipid profile [35].”
4. Pathogenesis
Line-101. I think that in this sentence, prevention must be included as a goal: “Understanding SCFE's pathogenesis precisely is crucial for both interpretation of the disease and the potential development of a rational therapeutic plan.”
Line -174: “The epiphyseal platebecomes hypoplastic and endochondral and intramembranous ossification are delayed in children with thyroid hormone insufficiency”. Please correct to: “The epiphyseal plate becomes hypoplastic and endochondral and intramembranous ossification are delayed in children with thyroid hormone insufficiency”.
Line 210. “SUFE” Can you explain or correct this acronym?
Figure 2. Can you correct the term hyperinsulinemia and the points of the scheme in the biomechanical factors part?
5. Summary
Line 298. Please add prevention: “for preventing and treating…”
Author Response
Thank you for the opportunity to review this manuscript. I congratulate the authors on the completion of this manuscript. Overall it is well written and on an important topic. The reflection is guided by an adequate compilation of facts and literature.
However, I have some comments and suggestions presented below
Response: We thank the reviewer for his kind comments.
Title
Please add to the title the type of manuscript: a narrative review.
Response: We added to the title the phrase “a narrative review”.
- Introduction
Line 45. Please, correct the format of this reference.
Response: We corrected the format of reference 10.
- Epidemiology
Line 60: “up to 4.1:1”, in what population?
Response: This analogy refers to Singapore population. We added this information, along with the proper reference: Lim Y-J, Kagda F, Lam KS, et al. Demographics and clinical presentation of slipped capital femoral epiphysis in Singapore: comparing the East with the West. J Pediatr Orthop B. 2008;17(6):289-292. doi:10.1097/BPB.0b013e32830cc379.
Table 2. To what specific timeframe refers the data presented as incidence.
Response: The presented incidence of each study refers to the time period that they were conducted. Each time period is presented in the “Study Years” column.
- Slipped capital femoral epiphysis and obesity
Line 94. “In a case-control study of 51 patients treated for SCFE, mean HbA1c levels were significantly higher than obese patients without the condition, but there were no differences in the lipid profile [35].” Please correct to: “In a case-control study of 51 patients treated for SCFE, mean HbA1c levels were significantly higher than in obese patients without the condition, but there were no differences in the lipid profile [35].”
Response: We made the suggested correction.
- Pathogenesis
Line-101. I think that in this sentence, prevention must be included as a goal: “Understanding SCFE's pathogenesis precisely is crucial for both interpretation of the disease and the potential development of a rational therapeutic plan.”
Response: We changed the sentence to “Understanding SCFE's pathogenesis precisely is crucial for both interpretation of the disease, the potential development of a rational therapeutic plan, as well as prevention strategies”.
Line -174: “The epiphyseal platebecomes hypoplastic and endochondral and intramembranous ossification are delayed in children with thyroid hormone insufficiency”. Please correct to: “The epiphyseal plate becomes hypoplastic and endochondral and intramembranous ossification are delayed in children with thyroid hormone insufficiency”.
Response: We made the suggested correction.
Line 210. “SUFE” Can you explain or correct this acronym?
Response: SUFE means slipped upper femoral epiphysis, but we changed it into SCFE, as this term is used throughout our manuscript.
Figure 2. Can you correct the term hyperinsulinemia and the points of the scheme in the biomechanical factors part?
Response: We corrected Figure 2.
- Summary
Line 298. Please add prevention: “for preventing and treating…”
Response: We made the suggested correction.
