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[The prognostic factors in perthes disease]
Andrzej Grzegorzewski1, Wiesław Szymczak, Marek Synder
1Katedra i Klinika Ortopedii i Ortopedii Dzieciqcej, Uniwersytet Medyczny w Lodzi.
Chirurgia Narzadow Ruchu I Ortopedia Polska
|November 30, 2006
Summary
Key risk factors for poor outcomes in Perthes disease include later onset age and specific radiological signs. Some factors like hip abduction and femoral head alignment can be modified during treatment to improve results.
Area of Science:
- Pediatric Orthopedics
- Radiology
- Clinical Outcomes Research
Context:
- Perthes disease affects hip development in children.
- Long-term outcomes are variable and influenced by multiple factors.
- Containment methods are standard treatment approaches.
Purpose:
- To identify clinical and radiological factors predicting late outcomes in Perthes disease.
- To determine if any identified risk factors can be modified during treatment.
- To stratify risk for both unilateral and bilateral Perthes disease.
Summary:
- This study analyzed 361 hips in 311 patients with Perthes disease treated with containment methods.
- Unilateral Perthes disease risk factors for poor outcomes include age ≥9 years, Catterall group 3-4, Herring C, acetabulum type III, limited abduction (<10°), premature growth arrest, ATD index <0.8, subluxation >20%, sphericity disturbance >5mm, Gage sign, and lateral calcification.
- Bilateral Perthes disease risk factors include age >6 years, Catterall group 3-4, Herring C, limited abduction (<10°), and lateral calcification.
- Factors like femoral head subluxation, acetabulum shape, and hip abduction can be addressed during the fragmentation stage to potentially improve outcomes.
Impact:
- Identifies specific predictors of long-term outcomes in Perthes disease.
- Provides clinicians with tools to assess prognosis during the fragmentation stage.
- Highlights modifiable factors that may allow for improved treatment strategies and patient outcomes.
