• This record comes from PubMed

Predictors of radiographic outcomes of conservative and surgical treatment of Legg-Calvé-Perthes disease

. 2022 Dec ; 46 (12) : 2869-2875. [epub] 20220929

Language English Country Germany Media print-electronic

Document type Journal Article, Research Support, Non-U.S. Gov't

Links

PubMed 36173477
DOI 10.1007/s00264-022-05584-x
PII: 10.1007/s00264-022-05584-x
Knihovny.cz E-resources

PURPOSE: Treatment outcomes of conservative and surgical treatment of Legg-Calvé-Perthes disease (LCPD) have been shown to be conditioned by a number of factors that may vary across different populations. This retrospective study aimed to evaluate factors affecting radiographically assessed treatment outcomes in patients treated surgically or conservatively for LCPD at Faculty Hospital Motol, Prague, Czech Republic, between the years 2006 and 2019. METHODS: Data of forty-seven children comprising 52 hips were analysed. Treatment outcomes were evaluated according to Stulberg classification. Predictors included the initial stage of fragmentation of the hip joint according to Herring classification, type of treatment (conservative or surgical), age at the time of diagnosis and sex. RESULTS: Older age and severity of LCPD according to Herring classification but not the type of treatment were the strongest factors determining treatment outcomes. Treatment outcomes were comparable in patients treated conservatively or surgically both across the whole cohort of patients and a group of young children < six years of age. CONCLUSIONS: Results strengthen the roles of severity of the LCPD at onset of treatment and age of the patient in predicting treatment outcomes in patients with LCPD. Conservative and surgical treatments appear to yield similar treatment outcomes irrespective of age of patients.

See more in PubMed

Catterall A (1971) The natural history of Perthes’ disease. J Bone Jt Surg Br 53:37–53 DOI

Manig M (2013) Legg-Calvé-Perthes disease (LCPD). Principles of diagnosis and treatment. Orthopade 42:891–894. https://doi.org/10.1007/s00132-013-2177-y PubMed DOI

Divi SN, Bielski RJ (2016) Legg-Calvé-Perthes disease. Pediatr Ann 45:e144–e149. https://doi.org/10.3928/00904481-20160310-03 PubMed DOI

Nguyen NA, Klein G, Dogbey G et al (2012) Operative versus nonoperative treatments for Legg-Calvé-Perthes disease: a meta-analysis. J Pediatr Orthop 32:697–705. https://doi.org/10.1097/BPO.0b013e318269c55d PubMed DOI

Westhoff B, Martiny F, Krauspe R (2013) Current treatment strategies in Legg-Calvé-Perthes disease. Orthopade 42:1008–1017. https://doi.org/10.1007/s00132-012-2048-y PubMed DOI

Kamegaya M, Saisu T, Ochiai N et al (2004) A paired study of Perthes’ disease comparing conservative and surgical treatment. J Bone Jt Surg Br 86:1176–1181. https://doi.org/10.1302/0301-620x.86b8.14458 DOI

Gent E, Antapur P, Mehta RL et al (2007) Predicting the outcome of Legg-Calvé-Perthes’ disease in children under 6 years old. J Child Orthop 1:159. https://doi.org/10.1007/s11832-007-0023-7 PubMed DOI PMC

Canavese F, Dimeglio A (2008) Perthes’ disease: prognosis in children under six years of age. J Bone Jt Surg Br 90:940–945. https://doi.org/10.1302/0301-620X.90B7.20691 DOI

Fabry K, Fabry G, Moens P (2003) Legg-Calvé-Perthes disease in patients under 5 years of age does not always result in a good outcome. Personal experience and meta-analysis of the literature. J Pediatr Orthop B 12:222–227. https://doi.org/10.1097/01.bpb.0000049583.53117.f7 PubMed DOI

Schoenecker PL, Stone JW, Capelli AM (1993) Legg-Perthes disease in children under 6 years old. Orthop Rev 22:201–208 PubMed

Herring JA (2011) Legg-Calvé-Perthes disease at 100: a review of evidence-based treatment. J Pediatr Orthop 31:S137–S140. https://doi.org/10.1097/BPO.0b013e318223b52d PubMed DOI

Wiig O, Huhnstock S, Terjesen T et al (2016) The outcome and prognostic factors in children with bilateral Perthes’ disease: a prospective study of 40 children with follow-up over five years. Bone Jt J 98-B:569–575. https://doi.org/10.1302/0301-620X.98B4.36045 DOI

Meurer A, Schwitalle M, Humke T et al (1999) Comparison of the prognostic value of the Catterall and Herring classification in patients with Perthes disease. Z Orthop Ihre Grenzgeb 137:168–172. https://doi.org/10.1055/s-2008-1039353 PubMed DOI

Wiig O, Terjesen T, Svenningsen S (2008) Prognostic factors and outcome of treatment in Perthes’ disease: a prospective study of 368 patients with five-year follow-up. J Bone Jt Surg Br 90:1364–1371. https://doi.org/10.1302/0301-620X.90B10.20649 DOI

Meurer A, Bohm B, Decking J, Heine J (2005) Analysis of acetabular changes in Morbus Perthes disease with radiomorphometry. Z Orthop Ihre Grenzgeb 143:100–105. https://doi.org/10.1055/s-2004-832408 PubMed DOI

Huhnstock S, Svenningsen S, Merckoll E et al (2017) Radiographic classifications in Perthes disease. Acta Orthop 88:522–529. https://doi.org/10.1080/17453674.2017.1340040 PubMed DOI PMC

Stulberg SD, Cooperman DR, Wallensten R (1981) The natural history of Legg-Calvé-Perthes disease. J Bone Jt Surg Am 63:1095–1108 DOI

Ross JR, Nepple JJ, Baca G et al (2012) Intraarticular abnormalities in residual Perthes and Perthes-like hip deformities. Clin Orthop Relat Res 470:2968–2977. https://doi.org/10.1007/s11999-012-2375-7 PubMed DOI PMC

Catterall A (1980) Natural history, classification, and x-ray signs in Legg-Calvé-Perthes’ disease. Acta Orthop Belg 46:346–351 PubMed

Nakamura J, Kamegaya M, Saisu T et al (2015) Outcome of patients with Legg-Calvé-Perthes onset before 6 years of age. J Pediatr Orthop 35:144–150. https://doi.org/10.1097/BPO.0000000000000246 PubMed DOI

Rosenfeld SB, Herring JA, Chao JC (2007) Legg-Calvé-perthes disease: a review of cases with onset before six years of age. J Bone Jt Surg Am 89:2712–2722. https://doi.org/10.2106/JBJS.G.00191 DOI

Oh H-S, Sung M-J, Lee Y-M et al (2021) Does the duration of each Waldenström stage affect the final outcome of Legg-Calvé-Perthes disease onset before 6 years of age? Children (Basel) 8:118. https://doi.org/10.3390/children8020118

Lee DS, Jung ST, Kim KH, Lee JJ (2009) Prognostic value of modified lateral pillar classification in Legg-Calvé-Perthes disease. Clin Orthop Surg 1:222–229. https://doi.org/10.4055/cios.2009.1.4.222 PubMed DOI PMC

Lappin K, Kealey D, Cosgrove A (2002) Herring classification: how useful is the initial radiograph? J Pediatr Orthop 22:479–482. https://doi.org/10.1097/00004694-200207000-00012 PubMed DOI

Ismail AM, Macnicol MF (1998) Prognosis in Perthes’ disease: a comparison of radiological predictors. J Bone Jt Surg Br 80:310–314. https://doi.org/10.1302/0301-620x.80b2.8054 DOI

Gent E, Antapur P, Fairhurst J et al (2006) Perthes’ disease in the very young child. J Pediatr Orthop B 15:16–22. https://doi.org/10.1097/01202412-200601000-00004 PubMed DOI

Price CT, Day DD, Flynn JC (1988) Behavioral sequelae of bracing versus surgery for Legg-Calvé-Perthes disease. J Pediatr Orthop 8:285–287. https://doi.org/10.1097/01241398-198805000-00006 PubMed DOI

Do DH, Valencia AA, Jo CH, Kim HKW (2022) Moderate weightbearing restricTIONS are associated with worse depressive symptoms and anxiety in children aged 5 to 7 years with Perthes disease. Clin Orthop Relat Res 480:587–599. https://doi.org/10.1097/CORR.0000000000002010 PubMed DOI

Menza B, Iacone D, Talwar D et al (2020) Socioeconomic deprivation and its adverse association with adolescent fracture care compliance. JB JS Open Access 5:e0064 DOI

Pillai A, Atiya S, Costigan PS (2005) The incidence of Perthes’ disease in Southwest Scotland. J Bone Jt Surg Br 87:1531–1535. https://doi.org/10.1302/0301-620X.87B11.16744 DOI

Stief F, Schmidt A, Adolf S et al (2016) Development of gait performance and dynamic hip and knee joint loading after containment improving surgery in patients with Legg-Calvé-Perthes disease. Gait Posture 47:51–56. https://doi.org/10.1016/j.gaitpost.2016.04.009 PubMed DOI

Westhoff B, Petermann A, Hirsch MA et al (2006) Computerized gait analysis in Legg Calvé Perthes disease–analysis of the frontal plane. Gait Posture 24:196–202. https://doi.org/10.1016/j.gaitpost.2005.08.008 PubMed DOI

Westhoff B, Martiny F, Reith A et al (2012) Computerized gait analysis in Legg-Calvé-Perthes disease–analysis of the sagittal plane. Gait Posture 35:541–546. https://doi.org/10.1016/j.gaitpost.2011.11.020 PubMed DOI

Find record

Citation metrics

Loading data ...

Archiving options

Loading data ...