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Arthroscopy in 19 children with Perthes' disease. Pathologic changes of the synovium and the joint surface
1Department of Orthopedics, Shiga Medical Center for Children, Japan.
Insights
Arthroscopy in children with Legg-Calvé-Perthes disease revealed significant synovial proliferation and labral hypervascularity. Hip joint irrigation during the procedure improved patient pain.
Area of Science:
- Pediatric Orthopedics
- Arthroscopy
- Hip Joint Pathologies
Background:
- Legg-Calvé-Perthes disease affects the hip joint in children.
- Synovial changes are a key feature of the disease process.
Purpose of the Study:
- To investigate arthroscopic findings in pediatric Legg-Calvé-Perthes disease.
- To evaluate the relationship between synovial changes and disease stage.
- To assess the therapeutic effect of arthroscopic irrigation on joint pain.
Main Methods:
- Arthroscopy of the hip joint was performed in 19 children.
- Histopathological examination of synovial tissue was conducted.
- Clinical outcomes, specifically joint pain, were recorded post-procedure.
Main Results:
- Pronounced synovial proliferation was observed in the acetabular fossa and capsule.
- Acetabular labrum showed hypervascularity across all disease stages.
- Synovial lining cell hyperplasia was noted, with minimal inflammation in early stages.
- Endothelial cell hypertrophy was evident in late stages.
Conclusions:
- Arthroscopy provides valuable insights into the synovial pathology of Legg-Calvé-Perthes disease.
- Hypervascularity of the acetabular labrum is a consistent finding.
- Arthroscopic irrigation offers symptomatic relief for joint pain in affected children.
Abstract:
Arthroscopy of the hip joint was performed in 19 children with Legg-Calvé-Perthes' disease. Proliferation of the synovium was pronounced both in the acetabular fossa and over the inner wall of the capsule. Hypervascularity was seen on the acetabular labrum in every stage of the disease. Microscopically, hyperplasia of the synovial lining cells was observed, but inflammatory changes in the synovial tissue were inconspicuous in the early stage of the disease. Although hypertrophy of the endothelial cells of the vessels was seen in the late stage of the disease, it was not distinct in the initial or fragmentation stages. Joint pain improved after irrigation during arthroscopy.