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Results after femoral and innominate osteotomy in Legg-Calvé-Perthes disease
A Moberg1, G Hansson, C Kaniklides
1Department of Orthopaedics, University Hospital, Uppsala, Sweden.
Insights
Innominate osteotomies provided better acetabular coverage for Legg-Calvé-Perthes disease patients than femoral osteotomies, with similar clinical and sphericity outcomes. Both surgical methods resulted in asymptomatic hips during daily activities.
Area of Science:
- Orthopedic surgery
- Pediatric orthopedics
- Hip joint biomechanics
Background:
- Legg-Calvé-Perthes disease affects the hip joint in children.
- Surgical management aims to improve hip joint congruency and preserve femoral head sphericity.
- Catterall classification is used to stage disease severity, with Groups 3 and 4 indicating more advanced disease.
Purpose of the Study:
- To compare the clinical and radiographic outcomes of femoral osteotomy versus innominate osteotomy in treating Legg-Calvé-Perthes disease.
- To evaluate the effect of each surgical technique on femoral head sphericity and acetabular coverage.
Main Methods:
- Retrospective study comparing 16 femoral osteotomies (Group A) and 18 innominate osteotomies (Group B).
- All patients had hips classified preoperatively as Catterall Group 3 or 4.
- Average follow-up was 6 years for Group A and 8 years for Group B.
Main Results:
- Clinical results were equivalent between the two groups, with all patients asymptomatic during daily activities.
- Radiographic assessment showed similar femoral head sphericity (Mose's index, epiphyseal quotient) in both groups.
- Innominate osteotomy group demonstrated superior acetabular coverage of the femoral head, indicated by a better center edge angle.
Conclusions:
- Both femoral and innominate osteotomies are effective in achieving asymptomatic hip function for advanced Legg-Calvé-Perthes disease.
- Innominate osteotomy offers an advantage in improving acetabular coverage of the femoral head compared to femoral osteotomy.
- Further research may explore long-term outcomes and optimal surgical timing for each procedure.
Abstract:
In a retrospective study of the surgical management of Legg-Calvé-Perthes disease, 16 femoral osteotomies (Group A) and 18 innominate osteotomies (Group B) were compared Smith regard to clinical and radiographic results. All hips were classified preoperatively as Catterall Group 3 or Group 4. The average followup period was 6 years in Group A and 8 years in Group B. The clinical results were the same in the 2 groups and all patients were asymptomatic in the affected hip(s) during daily activity. The radiographic results were also the same in the 2 groups with regard to measurements of the sphericity of the femoral head (Mose's index and epiphyseal quotient) but the coverage of the femoral head by the acetabulum (center edge angle) was better in the innominate osteotomy group.