Perthes Disease: Returning Children to Sports

In brief The authors provide guidelines for returning children with Perthes disease to sporting activities. They suggest maintenance of hip motion and containment of the femoral head in the acetabulum until the extent of the femoral epiphyseal necrosis can be determined. Swimming and adaptive physical therapy help regain the motion and strengthen the hip abductor muscles. Abduction brace therapy is continued in patients with a risk of femoral head deformity until reossification of the necrotic femoral head begins. Surgical containment, as an alternative to brace therapy, is recommended when an orthosis is not socially tolerated. Once reossification of the femoral head occurs, the patient may begin full activity, but osteochondritis dissecans with an osteocartilaginous loose body should be considered if catching or locking of the hip joint occurs.