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Legg-Calvé-Perthes disease
1Center for Excellence in Hip Disorders, Texas Scottish Rite Hospital, UT Southwestern Medical Center, Dallas, TX, USA.
The Journal of the American Academy of Orthopaedic Surgeons
|November 3, 2010
Summary
Legg-Calvé-Perthes disease causes femoral head deformity due to poor blood supply during growth. Treatment depends on age, with surgery showing mixed results in older children, highlighting the need for better therapies.
Area of Science:
- Orthopedics
- Pediatric Orthopedics
- Pediatric Bone Diseases
Background:
- Legg-Calvé-Perthes disease is an idiopathic hip condition characterized by ischemic necrosis of the developing femoral head.
- The primary long-term consequence is permanent femoral head deformity.
- Pathological repair, involving imbalanced bone resorption and formation, is implicated in the development of deformity.
Purpose of the Study:
- To review the pathogenesis, prognostic factors, and current treatment strategies for Legg-Calvé-Perthes disease.
- To evaluate the effectiveness of current treatments based on patient age and disease characteristics.
- To identify the need for improved therapeutic approaches.
Main Methods:
- Review of experimental studies and clinical evidence regarding Legg-Calvé-Perthes disease.
- Analysis of prognostic factors influencing treatment outcomes.
- Evaluation of surgical and non-surgical management strategies based on age at onset.
Main Results:
- Key prognostic indicators include degree of deformity, age at onset, extent of femoral head involvement, head-at-risk signs, and lateral pillar collapse.
- Non-surgical management is recommended for patients under 6 years old at onset.
- Surgical interventions yield good results in 40-60% of patients over 8 years old.
Conclusions:
- Treatment decisions for Legg-Calvé-Perthes disease should integrate age at onset, prognostic factors, and current evidence.
- The moderate success rate of surgical treatments in older children underscores the necessity for developing more effective therapies.
- Further research into the disease's pathobiology is crucial for advancing treatment efficacy.
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