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Epidemiology, natural evolution, pathogenesis, clinical spectrum, and management of Legg-Calvé-Perthes

Benjamin Joseph1, Hitesh Shah1, Daniel C Perry2,3,4

  • 1Kasturba Medical College, Manipal, India.

Journal of Children'S Orthopaedics
|October 6, 2023
PubMed

Insights

Legg-Calvé-Perthes disease, a childhood hip disorder, is declining in incidence. Current treatments aim to prevent or correct femoral head deformation, but evidence quality is poor, necessitating further research.

Area of Science:

  • Pediatric Orthopedics
  • Developmental Biology

Background:

  • Legg-Calvé-Perthes disease is a self-limiting childhood hip disorder caused by interrupted blood supply to the femoral epiphysis.
  • This review synthesizes current knowledge on its epidemiology, natural history, clinical presentation, and management.

Purpose of the Study:

  • To provide a comprehensive overview of Legg-Calvé-Perthes disease.
  • To summarize current understanding and identify research gaps in its management.

Main Methods:

  • A review of existing literature on Legg-Calvé-Perthes disease.
  • Synthesis of data on epidemiology, natural evolution, clinical spectrum, and treatment.

Main Results:

  • Environmental factors may contribute to Legg-Calvé-Perthes disease, with declining incidence rates observed.
  • The disease progresses through distinct radiographic stages (Ia-IV), with reversible deformation in early stages and irreversible in later stages.
  • Treatments vary by stage, focusing on containment and avoiding weight-bearing in early stages, and correction of deformity in later stages.

Conclusions:

  • The efficacy of current treatments for Legg-Calvé-Perthes disease is supported by low-quality evidence.
  • There is an urgent need for high-quality Level I studies to validate treatment effectiveness.
Abstract

Keywords:
Legg–Calvé–Perthes diseasecontainmentdeclining incidencesocial deprivationweight-relief

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