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

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.