Hip arthrodiastasis in Legg-Calvé-Perthes disease

Area of Science:

• Orthopaedic Surgery
• Paediatric Orthopaedics
• Hip Preservation

Background:

• Late-onset Perthes disease presents unique challenges in paediatric hip treatment.
• Arthrodiastasis offers a potential solution for hip joint distraction and mobilization.
• Assessing outcomes of arthrodiastasis in this specific patient cohort is crucial.

Purpose of the Study:

• To evaluate the efficacy of arthrodiastasis in treating late-onset Perthes disease.
• To analyze clinical and radiographic outcomes following the procedure.
• To report complication rates associated with arthrodiastasis in this population.

Main Methods:

• Ambispective review of 13 patients (age >8 years) with late-onset Perthes disease.
• Inclusion criteria: minimal deformity and poor prognosis.
• Assessment of mobility, pain (VAS), Trendelenburg sign, and radiographic sphericity.

Main Results:

• Significant pain reduction (mean VAS decrease of 3.83 points, P<.05).
• Cephalic sphericity maintained in 11 of 13 patients during 1.75 years follow-up.
• High complication rate (84.6%), primarily screw tract infections, all treatable.

Conclusions:

• Arthrodiastasis is a minimally invasive option for late-onset Perthes disease.
• The technique demonstrates potential for improving clinical results and preserving hip morphology.
• Patients must be informed of the significant, though often manageable, complication risks.