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The role of coagulation abnormalities in the development of Perthes' disease

W D Kealey1, E E Mayne, W McDonald

  • 1Department of Orthopaedic Surgery, Musgrave Park Hospital, Belfast, Northern Ireland, UK.

The Journal of Bone and Joint Surgery. British Volume
|August 30, 2000
PubMed

Insights

Perthes

Area of Science:

  • Pediatric Orthopedics
  • Hematology

Background:

  • Perthes' disease is a hip condition in children.
  • Previous studies suggested a link between Perthes' disease and thrombophilia or hypofibrinolysis.

Purpose of the Study:

  • To investigate the association between thrombophilia and Perthes' disease in a Northern Ireland cohort.
  • To determine if antithrombotic factor deficiencies or activated protein C resistance are etiological factors.

Main Methods:

  • A case-control study comparing 139 children with Perthes' disease to 220 healthy children.
  • Assays for antithrombotic factors (protein C, protein S, antithrombin III) and activated protein C resistance were performed.
  • Activated partial thromboplastin time was measured in both groups.

Main Results:

  • No significant deficiencies in antithrombotic factors or activated protein C resistance were found in children with Perthes' disease.
  • A significantly higher proportion (38.1%) of children with Perthes' disease had a prolonged activated partial thromboplastin time compared to controls (5.9%).
  • This suggests thrombophilia due to factor deficiency is not the primary cause of Perthes' disease.

Conclusions:

  • Thrombophilia linked to antithrombotic factor deficiency or activated protein C resistance is unlikely to be an etiological factor for Perthes' disease.
  • The cause of the prolonged activated partial thromboplastin time in Perthes' disease patients requires further investigation.

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