John Anthony Herring1. 1. Texas Scottish Rite Hospital for Children, Dallas, TX 75219, USA. tony.herring@tsrh.org
Abstract
BACKGROUND: The year 2010 is the 100th anniversary of the publication of the first 3 reports describing Legg- Calve-Perthes disease (LCPD). This paper summarizes available evidence previously published and discussed at the several world conferences honoring the occasion. METHODS: Relevant articles with evidence-based data regarding the efficacy of treatment methods for LCPD were reviewed by the author. RESULTS: The reviewed studies noted 3 factors related to outcome in patients treated for LCPD as follows: the age at onset, the classification of severity of femoral head involvement, and the type of treatment. In patients over age 8 at onset, surgical treatment with femoral varus osteotomy or Salter innominate osteotomy was associated with improved Stulberg outcomes compared with nonoperative treatment, in those who had lateral pillar B or B/C border class involvement. In the Wiig et al study, patients over age 6 with Catterall 3, 4 classification had better outcomes with these surgical treatment methods compared with nonoperative methods. Children under age 6 at onset had a good prognosis except for a small number of patients between age 4 and 6 years with lateral pillar C involvement. CONCLUSIONS: There is valid evidence of an association between surgical treatment of certain patients with LCPD and improved radiographic outcome.
BACKGROUND: The year 2010 is the 100th anniversary of the publication of the first 3 reports describing Legg- Calve-Perthes disease (LCPD). This paper summarizes available evidence previously published and discussed at the several world conferences honoring the occasion. METHODS: Relevant articles with evidence-based data regarding the efficacy of treatment methods for LCPD were reviewed by the author. RESULTS: The reviewed studies noted 3 factors related to outcome in patients treated for LCPD as follows: the age at onset, the classification of severity of femoral head involvement, and the type of treatment. In patients over age 8 at onset, surgical treatment with femoral varus osteotomy or Salter innominate osteotomy was associated with improved Stulberg outcomes compared with nonoperative treatment, in those who had lateral pillar B or B/C border class involvement. In the Wiig et al study, patients over age 6 with Catterall 3, 4 classification had better outcomes with these surgical treatment methods compared with nonoperative methods. Children under age 6 at onset had a good prognosis except for a small number of patients between age 4 and 6 years with lateral pillar C involvement. CONCLUSIONS: There is valid evidence of an association between surgical treatment of certain patients with LCPD and improved radiographic outcome.
Authors: Andrej Stančák; Jakub Kautzner; Petr Chládek; Ondřej Adamec; Vojtěch Havlas; Tomáš Trč Journal: Int Orthop Date: 2022-09-29 Impact factor: 3.479