Legg-Calvé-Perthes disease affecting children less than eight years of age: a paired outcome study

There is controversy as to whether operative treatment in Legg-Calvé-Perthes (LCP) disease improves the outcome obtained by conservative treatment. This article describes a paired study of mature patients, diagnosed with LCP disease before the age of 8 years, to compare the radiological results after conservative or surgical management. Patients were paired with strict matching of gender, body mass index, age at onset, disease stage at the first visit, necrotic area, and radiological at-risk signs. Each pair was assessed by comparing the values of five radiological measurements. Fourteen pairs (28 hips) fitted the criteria. The only radiological measure which showed a statistically better result in the surgical group was femoral head sphericity as measured by Mose's method. However, there was no difference between the two groups for Stulberg class. Our study supports the hypothesis that for hips affected with LCP disease under the age of 8 years, surgery does not improve the outcome.