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Legg-Calvé-Perthes Disease

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Hip Arthroscopy and Hip Joint Preservation Surgery

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Abstract

Legg-Calvé-Perthes disease (LCPD) is a self-limited condition characterized by avascular necrosis (AVN) of the pediatric femoral head. Though the precise pathophysiology and etiology of this disease remains a topic of debate, it is thought to be a result of disrupted blood flow to the capital femoral epiphysis. Patients usually present with a limp, with or without associated pain, as well as decreased hip abduction and internal rotation. Initial infarction and fragmentation of the femoral epiphysis is followed by revascularization, reossification, and remodeling of the femoral head. However, significant residual deformity of the proximal femur often remains. During the active stages of disease, most patients respond well to conservative management, though depending on age, more severe cases may benefit from operative intervention. Patients diagnosed before the age of 8 tend to have a favorable prognosis, whereas patients diagnosed at an older age tend to develop significant arthritis and dysfunction later in life.

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References

  1. Chou DT, Ramachandran M. Paediatric orthopaedics in clinical practice. London, UK: Springer; 2016. p. 91–105.

    Google Scholar 

  2. Sherk HH. Papers presented at the 2005 meeting of the musculoskeletal infections society: comment on the classics. Clin Orthop Relat Res. 2006;451:10.

    Article  Google Scholar 

  3. Wenger DR, Pandya NK. A brief history of Legg-Calvé-Perthes disease. J Pediatr Orthop. 2011;31:S130–S6.

    Article  PubMed  Google Scholar 

  4. Legg A. An obscure affection of the hip-joint. Boston Med Surg J. 1910;162(7):202–4.

    Article  Google Scholar 

  5. Perthes G. Uber Osteochondritis deformans juvenilis. Arch Klin Chir. 1913;101:779.

    Google Scholar 

  6. Calvé J. Sur une forme particuliere de pseudo-coxalgie greffée sur des déformations characteristiques de l’extremité superieure du femur. Rev Chir. 1910;30:54.

    Google Scholar 

  7. Konjetzny G. Zur patholgie and pathologischen anatomie der Perthes-Calvé schen krankheit. Acta Chir Scand. 1934;74:361–78.

    Google Scholar 

  8. Kim HK, Herring JA. Tachdjian’s pediatric orthopaedics. 4th ed. Philadelphia, PA, USA: Saunders/Elsevier; 2008. p. 580–629.

    Google Scholar 

  9. Loder RT, Skopelja EN. The epidemiology and demographics of legg-calve-perthes’ disease. ISRN Orthop. 2011;2011:504393.

    PubMed  PubMed Central  Google Scholar 

  10. Kealey WD, Mayne EE, McDonald W, Murray P, Cosgrove AP. The role of coagulation abnormalities in the development of Perthes’ disease. J Bone Joint Surg (Br). 2000;82(5):744–6.

    Article  CAS  Google Scholar 

  11. Hall AJ, Barker DJ, Dangerfield PH, Taylor JF. Perthes’ disease of the hip in Liverpool. Br Med J (Clin Res Ed). 1983;287(6407):1757–9.

    Article  CAS  Google Scholar 

  12. García Mata S, Ardanaz Aicua E, Hidalgo Ovejero A, Martinez-Grande M. Legg-Calvé-Perthes disease and passive smoking. J Pediatr Orthop. 2000;20(3):326–30.

    PubMed  Google Scholar 

  13. Perry DC, Bruce CE, Pope D, Dangerfield P, Platt MJ, Hall AJ. Legg-Calvé-Perthes disease in the UK: geographic and temporal trends in incidence reflecting differences in degree of deprivation in childhood. Arthritis Rheum. 2012;64(5):1673–9.

    Article  PubMed  Google Scholar 

  14. Mullan CJ, Thompson LJ, Cosgrove AP. The declining incidence of Legg-Calve-Perthes’ disease in Northern Ireland: an epidemiological study. J Pediatr Orthop. 2017;37(3):e178–e82.

    Article  PubMed  Google Scholar 

  15. Segev E, Ezra E, Wientroub S, Yaniv M, Hayek S, Hemo Y. Treatment of severe late-onset Perthes’ disease with soft tissue release and articulated hip distraction: revisited at skeletal maturity. J Child Orthop. 2007;1(4):229–35.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Osman MK, Martin DJ, Sherlock DA. Outcome of late-onset Perthes’ disease using four different treatment modalities. J Child Orthop. 2009;3(3):235–42.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Larson AN, Kim HKW, Herring JA. Female patients with late-onset Legg-Calvé-Perthes disease are frequently gymnasts: is there a mechanical etiology for this subset of patients? J Pediatr Orthop. 2013;33(8):811–5.

    Article  PubMed  Google Scholar 

  18. Joseph B, Mulpuri K, Varghese G. Perthes’ disease in the adolescent. J Bone Joint Surg (Br). 2001;83(5):715–20.

    Article  CAS  Google Scholar 

  19. Purry NA. The incidence of Perthes’ disease in three population groups in the Eastern Cape region of South Africa. J Bone Joint Surg. 1982;64(3):286–8.

    Article  CAS  Google Scholar 

  20. Georgiadis AG, Seeley MA, Yellin JL, Sankar WN. The presentation of Legg-Calvé-Perthes disease in females. J Child Orthop. 2015;9(4):243–7.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Guille JT, Lipton GE, Szoke G, Bowen JR, Harcke HT, Glutting JJ. Legg-Calve-Perthes disease in girls. A comparison of the results with those seen in boys. J Bone Joint Surg Am. 1998;80(9):1256–63.

    Article  CAS  PubMed  Google Scholar 

  22. Loder RT, Schwartz EM, Hensinger RN. Behavioral characteristics of children with Legg-Calvé-Perthes disease. J Pediatr Orthop. 1993;13(5):598–601.

    Article  CAS  PubMed  Google Scholar 

  23. Wiig O, Terjesen T, Svenningsen S, Lie SA. The epidemiology and aetiology of Perthes’ disease in Norway. A nationwide study of 425 patients. J Bone Joint Surg. 2006;88(9):1217–23.

    Article  CAS  Google Scholar 

  24. Schwarz E. The classic. A typical disease of the upper femoral epiphysis. By Erwin Schwarz. Clin Orthop Relat Res. 1986;209:5–12.

    Article  Google Scholar 

  25. Skaggs DL, Tolo VT. Legg-Calve-Perthes disease. J Am Acad Orthop Surg. 1996;4(1):9–16.

    Article  CAS  PubMed  Google Scholar 

  26. Chung SM. The arterial supply of the developing proximal end of the human femur. J Bone Joint Surg Am. 1976;58(7):961–70.

    Article  CAS  PubMed  Google Scholar 

  27. Trueta J. The normal vascular anatomy of the human femoral head during growth. J Bone Joint Surg (Br). 1957;39-b(2):358–94.

    Article  CAS  Google Scholar 

  28. Theron J. Angiography in Legg-Calve-Perthes disease. Radiology. 1980;135(1):81–92.

    Article  CAS  PubMed  Google Scholar 

  29. Atsumi T, Yamano K, Muraki M, Yoshihara S, Kajihara T. The blood supply of the lateral epiphyseal arteries in Perthes’ disease. J Bone Joint Surg (Br). 2000;82(3):392–8.

    Article  CAS  Google Scholar 

  30. Perry DC, Green DJ, Bruce CE, Pope D, Dangerfield P, Platt MJ, et al. Abnormalities of vascular structure and function in children with Perthes disease. Pediatrics. 2012;130(1):e126–31.

    Article  PubMed  Google Scholar 

  31. Liu SL, Ho TC. The role of venous hypertension in the pathogenesis of Legg-Perthes disease. A clinical and experimental study. J Bone Joint Surg Am. 1991;73(2):194–200.

    Article  CAS  PubMed  Google Scholar 

  32. Green NE, Griffin PP. Intra-osseous venous pressure in Legg-Perthes disease. J Bone Joint Surg Am. 1982;64(5):666–71.

    Article  CAS  PubMed  Google Scholar 

  33. Iwasaki K, Suzuki R, Okazaki T, Ikeda S, Inoue Y, Shimauchi R. The haemodynamics of Perthes’ disease. An intraosseous venographic study combined with measurement of the intramedullary pressure. Int Orthop. 1982;6(3):141–8.

    Article  CAS  PubMed  Google Scholar 

  34. Glueck CJ, Glueck HI, Greenfield D, Freiberg R, Kahn A, Hamer T, et al. Protein C and S deficiency, thrombophilia, and hypofibrinolysis: pathophysiologic causes of Legg-Perthes disease. Pediatr Res. 1994;35(4 Pt 1):383–8.

    Article  CAS  PubMed  Google Scholar 

  35. Glueck CJ, Crawford A, Roy D, Freiberg R, Glueck H, Stroop D. Association of antithrombotic factor deficiencies and hypofibrinolysis with Legg-Perthes disease. J Bone Joint Surg Am. 1996;78(1):3–13.

    Article  CAS  PubMed  Google Scholar 

  36. Eldridge J, Dilley A, Austin H, El-Jamil M, Wolstein L, Doris J, et al. The role of protein C, protein S, and resistance to activated protein C in Legg-Perthes disease. Pediatrics. 2001;107(6):1329–34.

    Article  CAS  PubMed  Google Scholar 

  37. Szepesi K, Posan E, Harsfalvi J, Ajzner E, Szucs G, Gaspar L, et al. The most severe forms of Perthes’ disease associated with the homozygous Factor V Leiden mutation. J Bone Joint Surg (Br). 2004;86(3):426–9.

    Article  CAS  Google Scholar 

  38. Kenet G, Ezra E, Wientroub S, Steinberg DM, Rosenberg N, Waldman D, et al. Perthes’ disease and the search for genetic associations: collagen mutations, Gaucher’s disease and thrombophilia. J Bone Joint Surg (Br). 2008;90(11):1507–11.

    Article  CAS  Google Scholar 

  39. Hayek S, Kenet G, Lubetsky A, Rosenberg N, Gitel S, Wientroub S. Does thrombophilia play an aetiological role in Legg-Calve-Perthes disease? J Bone Joint Surg (Br). 1999;81(4):686–90.

    Article  CAS  Google Scholar 

  40. Hresko MT, McDougall PA, Gorlin JB, Vamvakas EC, Kasser JR, Neufeld EJ. Prospective reevaluation of the association between thrombotic diathesis and legg-perthes disease. J Bone Joint Surg Am. 2002;84(9):1613–8.

    Article  PubMed  Google Scholar 

  41. Fisher RL. An epidemiological study of Legg-Perthes disease. J Bone Joint Surg Am. 1972;54(4):769–78.

    Article  CAS  PubMed  Google Scholar 

  42. Lee ST, Vaidya SV, Song HR, Lee SH, Suh SW, Telang SS. Bone age delay patterns in Legg-Calve-Perthes disease: an analysis using the Tanner and Whitehouse 3 method. J Pediatr Orthop. 2007;27(2):198–203.

    Article  PubMed  Google Scholar 

  43. Bohr HH. Skeletal maturation in Legg Calvé Perthes disease. Int Orthop. 1978;2(4):277–81.

    Article  Google Scholar 

  44. Kristmundsdottir F, Burwell RG, Harrison MH. Delayed skeletal maturation in Perthes’ disease. Acta Orthop Scand. 1987;58(3):277–9.

    Article  CAS  PubMed  Google Scholar 

  45. Wynne-Davies R, Gormley J. The aetiology of Perthes’ disease. Genetic, epidemiological and growth factors in 310 Edinburgh and Glasgow patients. J Bone Joint Surg (Br). 1978;60(1):6–14.

    Article  CAS  Google Scholar 

  46. Eckerwall G, Wingstrand H, Hagglund G, Karlberg J. Growth in 110 children with Legg-Calve-Perthes’ disease: a longitudinal infancy childhood puberty growth model study. J Pediatr Orthop B. 1996;5(3):181–4.

    Article  CAS  PubMed  Google Scholar 

  47. Shapiro F. Legg-Calve-Perthes disease: a study of lower extremity length discrepancies and skeletal maturation. Acta Orthop Scand. 1982;53(3):437–44.

    Article  CAS  PubMed  Google Scholar 

  48. Neidel J, Zander D, Hackenbroch MH. Low plasma levels of insulin-like growth factor I in Perthes’ disease. A controlled study of 59 consecutive children. Acta Orthop Scand. 1992;63(4):393–8.

    Article  CAS  PubMed  Google Scholar 

  49. Crofton PM, Macfarlane C, Wardhaugh B, Ranke MB, Elmlinger MW, Kelnar CJ, et al. Children with acute Perthes’ disease have asymmetrical lower leg growth and abnormal collagen turnover. Acta Orthop. 2005;76(6):841–7.

    Article  PubMed  Google Scholar 

  50. Matsumoto T, Enomoto H, Takahashi K, Motokawa S. Decreased levels of IGF binding protein-3 in serum from children with Perthes’ disease. Acta Orthop Scand. 1998;69(2):125–8.

    Article  CAS  PubMed  Google Scholar 

  51. Kealey WD, Lappin KJ, Leslie H, Sheridan B, Cosgrove AP. Endocrine profile and physical stature of children with Perthes disease. J Pediatr Orthop. 2004;24(2):161–6.

    Article  PubMed  Google Scholar 

  52. Grasemann H, Nicolai RD, Hauffa BP, Reinhardt W, Nicolai H, Hovel M. Skeletal immaturity, IGF-I and IGFBP-3 serum concentrations in Legg-Calve-Perthes disease (skeletal immaturity, IGF-I and IGFBP-3 in LCPD). Klin Padiatr. 1996;208(6):339–43.

    Article  CAS  PubMed  Google Scholar 

  53. Bahmanyar S, Montgomery SM, Weiss RJ, Ekbom A. Maternal smoking during pregnancy, other prenatal and perinatal factors, and the risk of Legg-Calve-Perthes disease. Pediatrics. 2008;122(2):e459–64.

    Article  PubMed  Google Scholar 

  54. Gordon JE, Schoenecker PL, Osland JD, Dobbs MB, Szymanski DA, Luhmann SJ. Smoking and socio-economic status in the etiology and severity of Legg-Calve-Perthes’ disease. J Pediatr Orthop B. 2004;13(6):367–70.

    Article  PubMed  Google Scholar 

  55. Robinson S, Harris H. Smoking and drinking among adults, 2009: a report on the 2009 General Lifestyle Survey. London: Office for National Statistics; 2011.

    Google Scholar 

  56. Dilley A, Hooper WC, Austin H, Jamil M, Miller C, Stokes M, et al. The beta fibrinogen gene G-455-A polymorphism is a risk factor for Legg-Perthes disease. J Thromb Haemost. 2003;1(11):2317–21.

    Article  CAS  PubMed  Google Scholar 

  57. Burch PR, Nevelos AB. Perthes’ disease: a new genetic hypothesis. Med Hypotheses. 1979;5(5):513–28.

    Article  CAS  PubMed  Google Scholar 

  58. Gray IM, Lowry RB, Renwick DH. Incidence and genetics of Legg-Perthes disease (osteochondritis deformans) in British Columbia: evidence of polygenic determination. J Med Genet. 1972;9(2):197–202.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  59. Miyamoto Y, Matsuda T, Kitoh H, Haga N, Ohashi H, Nishimura G, et al. A recurrent mutation in type II collagen gene causes Legg-Calve-Perthes disease in a Japanese family. Hum Genet. 2007;121(5):625–9.

    Article  CAS  PubMed  Google Scholar 

  60. Su P, Li R, Liu S, Zhou Y, Wang X, Patil N, et al. Age at onset-dependent presentations of premature hip osteoarthritis, avascular necrosis of the femoral head, or Legg-Calve-Perthes disease in a single family, consequent upon a p.Gly1170Ser mutation of COL2A1. Arthritis Rheum. 2008;58(6):1701–6.

    Article  CAS  PubMed  Google Scholar 

  61. Douglas G, Rang M. The role of trauma in the pathogenesis of the osteochondroses. Clin Orthop Relat Res. 1981;158:28–32.

    Article  Google Scholar 

  62. Hailer YD, Montgomery S, Ekbom A, Nilsson O, Bahmanyar S. Legg-Calvé-Perthes disease and the risk of injuries requiring hospitalization: a register study involving 2579 patients. Acta Orthop. 2012;83(6):572–6.

    Article  PubMed  PubMed Central  Google Scholar 

  63. Sanchis M, Zahir A, Freeman MA. The experimental simulation of Perthes disease by consecutive interruptions of the blood supply to the capital femoral epiphysis in the puppy. J Bone Joint Surg Am. 1973;55(2):335–42.

    Article  CAS  PubMed  Google Scholar 

  64. Kim HK, Su PH. Development of flattening and apparent fragmentation following ischemic necrosis of the capital femoral epiphysis in a piglet model. J Bone Joint Surg Am. 2002;84(8):1329–34.

    Article  PubMed  Google Scholar 

  65. Kim HK. Legg-Calve-Perthes disease: etiology, pathogenesis, and biology. J Pediatr Orthop. 2011;31(2 Suppl):S141–6.

    Article  PubMed  Google Scholar 

  66. Jonsater S. Coxa plana; a histo-pathologic and arthrografic study. Acta Orthop Scand Suppl. 1953;12:5–98.

    CAS  PubMed  Google Scholar 

  67. Andersen PE Jr, Schantz K, Bollerslev J, Justesen P. Bilateral femoral head dysplasia and osteochondritis. Multiple epiphyseal dysplasia tarda, spondylo-epiphyseal dysplasia tarda, and bilateral Legg-Perthes disease. Acta Radiol. 1988;29(6):705–9.

    Article  PubMed  Google Scholar 

  68. Catterall A. Adolescent hip pain after Perthes’ disease. Clin Orthop Relat Res. 1986;209:65–9.

    Article  Google Scholar 

  69. Kim HK, Herring JA. Legg-Calvé-Perthes disease. In: Herring JA, editor. Tachdjian’s pediatric orthopaedics: from the Texas Scottish Rite Hospital for Children. 2. 5 ed: Philadelphia, PA, USA: Saunders; 2013.

    Google Scholar 

  70. Inoue A, Ono K, Takaoka K, Yoshioka T, Hosoya T. A comparative study of histology in Perthes’ disease and idiopathic avascular necrosis of the femoral head in adults (IANF). Int Orthop. 1980;4(1):39–46.

    Article  CAS  PubMed  Google Scholar 

  71. Conway JJ. A scintigraphic classification of Legg-Calve-Perthes disease. Semin Nucl Med. 1993;23(4):274–95.

    Article  CAS  PubMed  Google Scholar 

  72. Dillman JR, Hernandez RJ. MRI of Legg-Calve-Perthes disease. AJR Am J Roentgenol. 2009;193(5):1394–407.

    Article  PubMed  Google Scholar 

  73. Park K-W, Rejuso CA, Cho W-T, Song H-R. Timing of premature physeal closure in Legg-Calve-Perthes disease. Int Orthop. 2014;38(10):2137–42.

    Article  PubMed  Google Scholar 

  74. Park K-W, Rejuso CA, Garcia R-AN, Kim T-W, Song H-R. Extent of physeal involvement in Legg–Calvé–Perthes disease. Int Orthop. 2014;38(11):2303–8.

    Article  PubMed  Google Scholar 

  75. Caffey J. The early roentgenographic changes in essential coxa plana: their significance in pathogenesis. Am J Roentgenol Radium Therapy, Nucl Med. 1968;103(3):620–34.

    Article  CAS  Google Scholar 

  76. Bowen JR, Schreiber FC, Foster BK, Wein BK. Premature femoral neck physeal closure in Perthes’ disease. Clin Orthop Relat Res. 1982;171:24–9.

    Article  Google Scholar 

  77. Catterall A, Pringle J, Byers PD, Fulford GE, Kemp HB, Dolman CL, et al. A review of the morphology of Perthes’ disease. J Bone Joint Surg (Br). 1982;64(3):269–75.

    Article  CAS  Google Scholar 

  78. Catterall A. Perthes’s disease. Br Med J. 1977;1(6069):1145–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  79. Waldenstrom H. The definite form of the Coxa Plana. Acta Radiol. 1922;1:384–94.

    Article  Google Scholar 

  80. Joseph B, Varghese G, Mulpuri K, Narasimha Rao K, Nair NS. Natural evolution of Perthes disease: a study of 610 children under 12 years of age at disease onset. J Pediatr Orthop. 2003;23(5):590–600.

    Article  PubMed  Google Scholar 

  81. Catterall A. The natural history of Perthes’ disease. J Bone Joint Surg (Br). 1971;53(1):37–53.

    Article  CAS  Google Scholar 

  82. Herring JA, Neustadt JB, Williams JJ, Early JS, Browne RH. The lateral pillar classification of Legg-Calve-Perthes disease. J Pediatr Orthop. 1992;12(2):143–50.

    Article  CAS  PubMed  Google Scholar 

  83. Salter RB, Thompson GH. Legg-Calve-Perthes disease. The prognostic significance of the subchondral fracture and a two-group classification of the femoral head involvement. J Bone Joint Surg Am. 1984;66(4):479–89.

    Article  CAS  PubMed  Google Scholar 

  84. Stulberg SD, Cooperman DR, Wallensten R. The natural history of Legg-Calve-Perthes disease. J Bone Joint Surg Am. 1981;63(7):1095–108.

    Article  CAS  PubMed  Google Scholar 

  85. Waldenstrom H. The classic. The first stages of coxa plana by Henning Waldenstrom. Clin Orthop Relat Res. 1938;1984(191):4–7.

    Google Scholar 

  86. Farsetti P, Benedetti-Valentini M, Potenza V, Ippolito E. Valgus extension femoral osteotomy to treat “hinge abduction” in Perthes’ disease. J Child Orthop. 2012;6(6):463–9.

    Article  PubMed  PubMed Central  Google Scholar 

  87. Laine JC, Martin BD, Novotny SA, Kelly DM. Role of advanced imaging in the diagnosis and management of active Legg-Calve-Perthes disease. J Am Acad Orthop Surg. 2018;26(15):526–36.

    Article  PubMed  Google Scholar 

  88. Song HR, Lee SH, Na JB, Tymowsi GI, Cho SH, Koo KH. Relationship between lateral subluxation and widening of medial joint space in Legg-Calvé-Perthes disease. J Pediatr Orthop. 1998;18(5):637–42.

    Article  CAS  PubMed  Google Scholar 

  89. Kim HK. Legg-Calve-Perthes disease. J Am Acad Orthop Surg. 2010;18(11):676–86.

    Article  PubMed  Google Scholar 

  90. Herring JA, Williams JJ, Neustadt JN, Early JS. Evolution of femoral head deformity during the healing phase of Legg-Calve-Perthes disease. J Pediatr Orthop. 1993;13(1):41–5.

    Article  CAS  PubMed  Google Scholar 

  91. Herring JA, Kim HT, Browne R. Legg-Calve-Perthes disease. Part I: Classification of radiographs with use of the modified lateral pillar and Stulberg classifications. J Bone Joint Surg Am. 2004;86(10):2103–20.

    Article  PubMed  Google Scholar 

  92. Stulberg SD, Cooperman DR, Wallensten R. The natural history of Legg-Calvé-Perthes disease. J Bone Joint Surg Am. 1981;63(7):1095–108.

    Article  CAS  PubMed  Google Scholar 

  93. Larson AN, Sucato DJ, Herring JA, Adolfsen SE, Kelly DM, Martus JE, et al. A prospective multicenter study of Legg-Calvé-Perthes disease: functional and radiographic outcomes of nonoperative treatment at a mean follow-up of twenty years. J Bone Joint Surg Am. 2012;94(7):584–92.

    Article  PubMed  Google Scholar 

  94. Larson AN, Sucato DJ, Herring JA, Adolfsen SE, Kelly DM, Martus JE, et al. A prospective multicenter study of Legg-Calvé-Perthes disease. J Bone Joint Surg Am. 2012;94(7):584–92.

    Article  PubMed  Google Scholar 

  95. Herring JA, Kim HT, Browne R. Legg-Calve-Perthes disease. Part II: Prospective multicenter study of the effect of treatment on outcome. J Bone Joint Surg Am. 2004;86(10):2121–34.

    Article  PubMed  Google Scholar 

  96. Ritterbusch JF, Shantharam SS, Gelinas C. Comparison of lateral pillar classification and Catterall classification of Legg-Calve-Perthes’ disease. J Pediatr Orthop. 1993;13(2):200–2.

    CAS  PubMed  Google Scholar 

  97. Gigante C, Frizziero P, Turra S. Prognostic value of Catterall and Herring classification in Legg-Calve-Perthes disease: follow-up to skeletal maturity of 32 patients. J Pediatr Orthop. 2002;22(3):345–9.

    PubMed  Google Scholar 

  98. Park MS, Chung CY, Lee KM, Kim TW, Sung KH. Reliability and stability of three common classifications for Legg-Calve-Perthes disease. Clin Orthop Relat Res. 2012;470(9):2376–82.

    Article  PubMed  PubMed Central  Google Scholar 

  99. Joseph B, Nair NS, Narasimha Rao K, Mulpuri K, Varghese G. Optimal timing for containment surgery for Perthes disease. J Pediatr Orthop. 2003;23(5):601–6.

    Article  PubMed  Google Scholar 

  100. Kaniklides C, Lönnerholm T, Moberg A, Sahlstedt B. Legg-Calvé-Perthes disease. Acta Radiol. 1995;36(4):434–9.

    Article  CAS  PubMed  Google Scholar 

  101. Du J, Lu A, Dempsey M, Herring JA, Kim HK. MR perfusion index as a quantitative method of evaluating epiphyseal perfusion in Legg-Calve-Perthes disease and correlation with short-term radiographic outcome: a preliminary study. J Pediatr Orthop. 2013;33(7):707–13.

    Article  PubMed  Google Scholar 

  102. Yoo WJ, Choi IH, Cho TJ, Jang W, Chung CY, Park MS, et al. Risk factors for femoral head deformity in the early stage of Legg-Calve-Perthes disease: MR contrast enhancement and diffusion indexes. Radiology. 2016;279(2):562–70.

    Article  PubMed  Google Scholar 

  103. Weishaupt D, Exner GU, Hilfiker PR, Hodler J. Dynamic MR imaging of the hip in Legg-Calve-Perthes disease: comparison with arthrography. AJR Am J Roentgenol. 2000;174(6):1635–7.

    Article  CAS  PubMed  Google Scholar 

  104. James SLJ, Ali K, Malara F, Young D, O’Donnell J, Connell DA. MRI findings of femoroacetabular impingement. Am J Roentgenol. 2006;187(6):1412–9.

    Article  Google Scholar 

  105. Mintz DN, Hooper T, Connell D, Buly R, Padgett DE, Potter HG. Magnetic resonance imaging of the hip: detection of labral and chondral abnormalities using noncontrast imaging. Arthroscopy. 2005;21(4):385–93.

    Article  PubMed  Google Scholar 

  106. Divi SN, Bielski RJ. Legg-Calvé-Perthes disease. Pediatr Ann. 2016;45(4):e144–e9.

    Article  PubMed  Google Scholar 

  107. Moya-Angeler J, Abril JC, Rodriguez IV. Legg-Calvé-Perthes disease: role of isolated adductor tenotomy? Eur J Orthop Surg Traumatol. 2013;23(8):921–5.

    Article  PubMed  Google Scholar 

  108. Eckerwall G, Hochbergs P, Wingstrand H, Egund N. Sonography and intracapsular pressure in Perthes’ disease. 39 children examined 2-36 months after onset. Acta Orthop Scand. 1994;65(6):575–80.

    Article  CAS  PubMed  Google Scholar 

  109. Guille JT, Lipton GE, Tsirikos AI, Bowen JR. Bilateral Legg-Calve-Perthes disease: presentation and outcome. J Pediatr Orthop. 2002;22(4):458–63.

    PubMed  Google Scholar 

  110. Crossan JF, Wynne-Davies R, Fulford GE. Bilateral failure of the capital femoral epiphysis: bilateral Perthes disease, multiple epiphyseal dysplasia, pseudoachondroplasia, and spondyloepiphyseal dysplasia congenita and tarda. J Pediatr Orthop. 1983;3(3):297–301.

    Article  CAS  PubMed  Google Scholar 

  111. McAndrew MP, Weinstein SL. A long-term follow-up of Legg-Calve-Perthes disease. J Bone Joint Surg Am. 1984;66(6):860–9.

    Article  CAS  PubMed  Google Scholar 

  112. Gower WE, Johnston RC. Legg-Perthes disease. Long-term follow-up of thirty-six patients. J Bone Joint Surg Am. 1971;53(4):759–68.

    Article  CAS  PubMed  Google Scholar 

  113. Joseph B, Price CT. Principles of containment treatment aimed at preventing femoral head deformation in Perthes disease. Orthop Clin North Am. 2011;42(3):317–27, vi

    Article  PubMed  Google Scholar 

  114. Barquet A. Natural history of avascular necrosis following traumatic hip dislocation in childhood: a review of 145 cases. Acta Orthop Scand. 1982;53(5):815–20.

    Article  CAS  PubMed  Google Scholar 

  115. Bradley CS, Perry DC, Wedge JH, Murnaghan ML, Kelley SP. Avascular necrosis following closed reduction for treatment of developmental dysplasia of the hip: a systematic review. J Child Orthop. 2016;10(6):627–32.

    Article  PubMed  PubMed Central  Google Scholar 

  116. Thulasidhar AN, Kumar S, Aroor S, Mundkur S. Avascular necrosis of femoral head in a child with beta thalassaemia major. J Clin Diagn Res. 2016;10(9):SL03–SL.

    PubMed  PubMed Central  Google Scholar 

  117. Yassin MA, Moustafa AH, Nashwan AJ, Soliman AT, El Derhoubi H, Mohamed SF, et al. Dasatinib induced avascular necrosis of femoral head in adult patient with chronic myeloid leukemia. Clin Med Insights Blood Disord. 2015;8:19–23.

    Article  PubMed  PubMed Central  Google Scholar 

  118. Cruess RL. Steroid-induced osteonecrosis: a review. Can J Surg. 1981;24(6):567–71.

    CAS  PubMed  Google Scholar 

  119. Mahadeo KM, Oyeku S, Taragin B, Rajpathak SN, Moody K, Santizo R, et al. Increased prevalence of osteonecrosis of the femoral head in children and adolescents with sickle-cell disease. Am J Hematol. 2011;86(9):806–8.

    Article  PubMed  Google Scholar 

  120. Krakow D. Skeletal dysplasias. Clin Perinatol. 2015;42(2):301–viii.

    Article  PubMed  PubMed Central  Google Scholar 

  121. Mazloumi SM, Ebrahimzadeh MH, Kachooei AR. Evolution in diagnosis and treatment of Legg-Calve-Perthes disease. Arch Bone Jt Surg. 2014;2(2):86–92.

    PubMed  PubMed Central  Google Scholar 

  122. Price CT, Thompson GH, Wenger DR. Containment methods for treatment of Legg-Calvé-Perthes disease. Orthop Clin North Am. 2011;42(3):329–vi.

    Article  PubMed  Google Scholar 

  123. Green NE, Beauchamp RD, Griffin PP. Epiphyseal extrusion as a prognostic index in Legg-Calvé-Perthes disease. J Bone Joint Surg Am. 1981;63(6):900–5.

    Article  CAS  PubMed  Google Scholar 

  124. Farsetti P, Tudisco C, Caterini R, Potenza V, Ippolito E. The Herring lateral pillar classification for prognosis in Perthes disease. Late results in 49 patients treated conservatively. J Bone Joint Surg. 1995;77(5):739–42.

    Article  CAS  Google Scholar 

  125. Ismail AM, Macnicol MF. Prognosis in Perthes’ disease: a comparison of radiological predictors. J Bone Joint Surg. 1998;80(2):310–4.

    Article  CAS  Google Scholar 

  126. Rosenfeld SB, Herring JA, Chao JC. Legg-calve-perthes disease: a review of cases with onset before six years of age. J Bone Joint Surg Am. 2007;89(12):2712–22.

    Article  PubMed  Google Scholar 

  127. Stanitski CL. Hip range of motion in Perthes’ disease: comparison of pre-operative and intra-operative values. J Child Orthop. 2007;1(1):33–5.

    Article  PubMed  PubMed Central  Google Scholar 

  128. Canavese F, Dimeglio A. Perthes’ disease: prognosis in children under six years of age. J Bone Joint Surg. 2008;90(7):940–5.

    Article  CAS  Google Scholar 

  129. Rich MM, Schoenecker PL. Management of Legg-Calvé-Perthes disease using an A-frame orthosis and hip range of motion: a 25-year experience. J Pediatr Orthop. 2013;33(2):112–9.

    Article  PubMed  Google Scholar 

  130. Wiig O, Terjesen T, Svenningsen S. Prognostic factors and outcome of treatment in Perthes’ disease: a prospective study of 368 patients with five-year follow-up. J Bone Joint Surg. 2008;90(10):1364–71.

    Article  CAS  Google Scholar 

  131. Nelitz M, Lippacher S, Krauspe R, Reichel H. Perthes disease: current principles of diagnosis and treatment. Dtsch Arztebl Int. 2009;106(31–32):517–23.

    PubMed  PubMed Central  Google Scholar 

  132. Carney BT, Minter CL. Nonsurgical treatment to regain hip abduction motion in Perthes disease: a retrospective review. South Med J. 2004;97(5):485–8.

    Article  PubMed  Google Scholar 

  133. Carpenter BN. Legg-Calve-Perthes disease. Phys Ther. 1975;55(3):242–9.

    Article  CAS  PubMed  Google Scholar 

  134. Hardesty CK, Liu RW, Thompson GH. The role of bracing in Legg-Calve-Perthes disease. J Pediatr Orthop. 2011;31(2 Suppl):S178–S81.

    Article  PubMed  Google Scholar 

  135. Copeliovitch L. Femoral varus osteotomy in Legg-Calve-Perthes disease. J Pediatr Orthop. 2011;31:S189–S91.

    Article  PubMed  Google Scholar 

  136. Karpinski MR, Newton G, Henry AP. The results and morbidity of varus osteotomy for Perthes’ disease. Clin Orthop Relat Res. 1986;209:30–40.

    Article  Google Scholar 

  137. Salter RB. Legg-Perthes disease: the scientific basis for the methods of treatment and their indications. Clin Orthop Relat Res. 1980;150:8–11.

    Article  Google Scholar 

  138. Thompson GH. Salter osteotomy in Legg-Calvé-Perthes disease. J Pediatr Orthop. 2011;31(2 Suppl):S192–S7.

    Article  PubMed  Google Scholar 

  139. Wenger DR, Pandya NK. Advanced containment methods for the treatment of Perthes disease: Salter plus varus osteotomy and triple pelvic osteotomy. J Pediatr Orthop. 2011;31(2 Suppl):S198–205.

    Article  PubMed  Google Scholar 

  140. Ghanem I, Haddad E, Haidar R, Haddad-Zebouni S, Aoun N, Dagher F, et al. Lateral shelf acetabuloplasty in the treatment of Legg-Calvé-Perthes disease: improving mid-term outcome in severely deformed hips. J Child Orthop. 2010;4(1):13–20.

    Article  PubMed  Google Scholar 

  141. Reddy RR, Morin C. Chiari osteotomy in Legg-Calve-Perthes disease. J Pediatr Orthop B. 2005;14(1):1–9.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA

    Joseph Serino III & Monica Kogan

  2. Department of Orthopaedic Surgery, Medical College of Wisconsin, Wauwatosa, WI, USA

    Jonathan Rasio

  3. Pediatric Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA

    Monica Kogan

  4. Department of Orthopedic Surgery, Division of Sports Medicine, Section of Young Adult Hip Surgery, Rush Medical College of Rush University, Rush University Medical Center, Chicago, IL, USA

    Jonathan Rasio

Authors
  1. Joseph Serino III
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  2. Jonathan Rasio
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  3. Monica Kogan
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Editor information

Editors and Affiliations

  1. Department of Orthopaedic Surgery, Division of Sports Medicine, Section of Young Adult Hip Surgery, Rush University Medical Center, Chicago, IL, USA

    Shane J. Nho

  2. Sports Medicine and Shoulder Service, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA

    Asheesh Bedi

  3. Department of Orthopaedic Surgery, Joint Preservation and Cartilage Restoration Center, University Hospitals Case Medical Center, Cleveland, OH, USA

    Michael J. Salata

  4. Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC, USA

    Richard C. Mather III

  5. Department of Orthopaedic Surgery, Sports Medicine and Shoulder Service, Center for Hip Preservation Surgery Weill Medical College of Cornell University, Hospital for Special Surgery, New York, NY, USA

    Bryan T. Kelly

Section Editor information

  1. Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO, USA

    Jeffrey J. Nepple

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Serino, J., Rasio, J., Kogan, M. (2022). Legg-Calvé-Perthes Disease. In: Nho, S.J., Bedi, A., Salata, M.J., Mather III, R.C., Kelly, B.T. (eds) Hip Arthroscopy and Hip Joint Preservation Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-43240-9_124

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  • DOI: https://doi.org/10.1007/978-3-030-43240-9_124

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