[Analysis of acetabular changes in Morbus Perthes disease with radiomorphometry]

Area of Science:

• Pediatric Orthopedics
• Hip Dysplasia Research

Background:

• Perthes disease commonly causes acetabular depth and irregularity secondary to femoral head changes.
• Early therapeutic intervention is crucial to prevent long-term acetabular deformities.

Purpose of the Study:

• To evaluate how femoral head involvement and patient age impact acetabular development and treatment outcomes in Perthes disease.
• To compare the effectiveness of conservative versus operative treatment strategies based on disease severity.

Main Methods:

• Radiomorphometric analyses (epiphyseal ratio, acetabular ratio, acetabulum-head ratio) were performed on 76 affected hips in 66 patients.
• Patients were classified using the Catterall classification at diagnosis and Mose classification at follow-up.
• Treatment groups included conservative, operative (IVO), and sequential conservative-operative interventions.

Main Results:

• A correlation was observed between Catterall classification and radiographic parameters, with higher Catterall groups showing worse outcomes.
• Operative treatment in Catterall IV patients showed mixed results, with better acetabular-head and acetabular ratios compared to conservative treatment.
• Patients in Catterall I and II groups achieved favorable outcomes regardless of treatment approach.

Conclusions:

• Operative intervention appears more beneficial than conservative therapy for severe Perthes disease (higher Catterall groups).
• The extent of secondary acetabular changes is directly proportional to the degree of femoral head involvement.