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Risk Factors for Developing Perthes Disease: A Comprehensive National Analysis Spanning 2 Decades

Tanya Boghosian1, David Momtaz2, Jad Lawand3

  • 1Department of Orthopaedics, Washington University School of Medicine, Saint Louis, MO.

Journal of Pediatric Orthopedics
|March 6, 2025
PubMed

Insights

Perthes disease risk factors identified include male sex, white race, obesity, tobacco exposure, hypertension, and thrombophilia. Thrombophilia showed the highest odds, offering insights into disease etiology.

Area of Science:

  • Pediatric Orthopedics
  • Epidemiology
  • Genetics

Background:

  • Perthes disease is a pediatric hip condition causing femoral head necrosis with unknown etiology.
  • Identifying risk factors is crucial for early diagnosis and intervention in Perthes disease.
  • This study investigated risk factors in a large patient cohort.

Purpose of the Study:

  • To analyze independent risk factors associated with the development of Perthes disease.
  • To identify demographic and clinical factors influencing Perthes disease incidence.
  • To provide insights into the etiology of Perthes disease.

Main Methods:

  • A Level III prognostic case-control study utilizing a U.S. national database (2003-2023).
  • Compared 4034 patients with Perthes disease to 3,483,745 age-matched controls.
  • Multivariable logistic regression models were used to calculate adjusted odds ratios (AOR) and 95% confidence intervals.

Main Results:

  • Male sex (AOR: 3.14), white race (AOR: 2.16), and obesity (AOR: 2.21) were significant risk factors.
  • Black (AOR: 0.26), Hispanic (AOR: 0.53), and Asian (AOR: 0.55) races showed lower odds.
  • Hypertension (AOR: 1.64), tobacco exposure (AOR: 1.25), and thrombophilia (AOR: 9.17) were also significant risk factors.

Conclusions:

  • This large-scale study identified key risk factors for Perthes disease, including demographic and clinical elements.
  • Thrombophilia emerged as a significant, albeit rare, risk factor with the highest AOR.
  • Findings suggest potential roles for vascular and metabolic pathways in Perthes disease etiology.
Abstract

Keywords:
Perthes diseasehypertensionmale gendernational databaseobesitypediatric patientsrisk factorsthrombophiliatobacco exposure

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