Perthes disease: evaluation and management

Area of Science:

• Pediatric Orthopedics
• Avascular Necrosis
• Hip Joint Pathologies

Background:

• Perthes disease is a self-limiting condition involving idiopathic avascular necrosis of the capital femoral epiphysis in children.
• Despite over a century since its initial description, there is no established consensus on the optimal treatment strategy.
• The primary goal of treatment is to maintain the sphericity of the femoral head and the congruency of the femur-acetabulum relationship.

Purpose of the Study:

• To review the current understanding and treatment goals for Perthes disease.
• To emphasize the importance of preserving femoral head morphology and hip joint congruency.
• To highlight the role of early diagnosis and management in preventing long-term complications.

Main Methods:

• This review synthesizes existing literature on Perthes disease.
• It focuses on the biomechanical principles guiding treatment decisions.
• The impact of early intervention on disease progression is discussed.

Main Results:

• Maintaining femoral head sphericity is crucial for preventing secondary degenerative arthritis.
• Femur-acetabulum congruency is essential for optimal hip function.
• Early diagnosis and appropriate management can mitigate femoral head collapse and deformity.

Conclusions:

• Effective management of Perthes disease focuses on preserving the natural architecture of the hip joint.
• Preventing progressive deformity and impingement is key to long-term outcomes.
• Early intervention strategies are vital for improving prognosis and reducing the risk of osteoarthritis.