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[Legg-Calve-Perthes disease]
1Hôpital orthopédique de la Suisse romande, avenue Pierre-Decker 4, 1005 Lausanne, Suisse. Michel.Dutoit@chuv.ch
Summary
Legg-Calvé-Perthes disease (LCPD) treatment is challenging, with prognosis depending on age, necrosis extent, and hip extrusion. Current treatments aim to minimize femoral head deformity and prevent future arthritis.
Area of Science:
- Orthopedics
- Pediatric Orthopedics
- Radiology
Context:
- Legg-Calvé-Perthes disease (LCPD) is a hip disorder affecting children.
- Accurate diagnosis and prognosis are crucial for effective management.
- Advances in imaging aid in treatment planning and outcome prediction.
Purpose:
- To review the definition, etiology, and clinical manifestations of LCPD.
- To highlight the importance of diagnostic investigations for prognosis.
- To discuss current conservative and surgical treatment strategies and their complications.
Summary:
- Key prognostic factors for LCPD include patient age at diagnosis, extent of epiphyseal necrosis (especially the lateral pillar), and hip extrusion.
- No causal treatment exists; management focuses on preventing femoral head deformity and secondary osteoarthritis.
- Prognosis is favorable in children under 5, but less so after age 9, even with surgical intervention.
Impact:
- Informs clinical decision-making for LCPD management.
- Aids in patient counseling regarding treatment outcomes and long-term prognosis.
- Contributes to understanding the natural history and optimal therapeutic approaches for LCPD.
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