Biologic osteotomy in Perthes disease

This is a study to demonstrate the biologic effect of a proximal femoral osteotomy in Perthes disease. Fifty-two hips in 49 patients treated with prolonged recumbency in a Robert Jones abduction frame were reviewed. Twenty-six of these hips had, in addition, a proximal femoral osteotomy. No significant relation between the treatment group and Mose rating (p greater than 0.05), epiphyseal quotient (p greater than 0.05), or healing rate (p greater than 0.05) was found. In the group of patients with Catterall III and IV disease, there were 44% good, 29% fair, and 29% poor results. Based on this study, the biologic aspect of the osteotomy probably does not influence the radiologic outcome or the healing rate in Perthes disease; hence, the beneficial effects of a containment osteotomy probably occur as a result of mechanical rather than biologic means.