Legg‐Calvé‐Perthes Disease

@article{Kim2010LeggCalvPerthesD,
  title={Legg‐Calv{\'e}‐Perthes Disease},
  author={Harry K.W. Kim},
  journal={American Academy of Orthopaedic Surgeon},
  year={2010},
  volume={18},
  pages={676–686}
}
  • H. Kim
  • Published 1 November 2010
  • Medicine
  • American Academy of Orthopaedic Surgeon
&NA; Legg‐Calvé‐Perthes disease is an idiopathic hip disorder that produces ischemic necrosis of the growing femoral head. Permanent femoral head deformity is the most significant sequela. Experimental studies indicate that the pathologic repair process, which is marked by an imbalance of bone resorption and formation, contributes to the pathogenesis of femoral head deformity. Important prognostic factors include degree of deformity, age at disease onset, extent of head involvement, head‐at… 
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Legg-calvé-perthes disease: Treatments

Even though there is no resounding consensus of the best treatment of LCPD, there is an agreement on the primary goal of treatment – to maintain femoral head sphericity or minimize further deformity if already present.

Legg-Calvé-Perthes Disease

  • F. Shapiro
  • Medicine
    Pediatric Orthopedic Deformities, Volume 2
  • 2019
The structural changes of the femoral head and acetabulum at skeletal maturity can vary from near normal to highly irregular, the more severe of which predispose the hip to degenerative arthritis in later years.

Legg-Calvé-Perthes disease

A review of the newest available literature concerning the diagnosis and treatment of Legg-Calvé-Perthes disease in children and young adults focuses on the residual deformity characteristic of LCPD.

Arthrodiastasis for late onset Perthes' disease using a simple frame and limited soft tissue release: early results.

Minimal soft tissue release and hip distraction can be regarded as a salvage procedure for late onset Perthes' disease with hip pain, at the stage of necrosis or fragmentation, with a statistically significant difference between pre and post-operative values.

Legg-Calvé-Perthes Disease: Diagnosis, Imaging, and Classifications

The diagnosis of LCPD requires plain radiography and careful history taking as its symptoms and physical findings are nonspecific and it is a diagnosis of exclusion.

Ischemic femoral head osteonecrosis in a piglet model causes three dimensional decrease in acetabular coverage

  • V. UpasaniM. Jeffords H. Kim
  • Medicine
    Journal of orthopaedic research : official publication of the Orthopaedic Research Society
  • 2018
It is indicated that the development of femoral head deformity following ischemic osteonecrosis produces specific and predictable changes to the shape of the acetabulum.

A Comparison of the Effectiveness of Surgical and Nonsurgical Treatment of Legg-Calve-Perthes Disease: A Review of the Literature

Research provides some evidence to suggest that nontreatment of Legg-Calve-Perthes disease may be as effective as orthotic or surgical intervention, and more research is required to determine the effectiveness of orthotic and surgical treatment.

Childhood Femoral Head Osteonecrosis

This review focuses on childhood FHO with a special attention to the conditions that are more commonly seen in the pediatric population: Legg-Calve-Perthes disease, corticosteroid-associated FHO, and sickle cell disease.

Skeletal immaturity, rostral sparing, and disparate hip morphologies as biomechanical causes for Legg‐Calvé‐Perthes' disease

An overview of the literature is presented, summarizing the current understanding of the pathogenesis, particularly related to how the formation of the vasculature to the femoral epiphysis places children aged 5–8 at a higher risk for Perthes' disease, and how skeletal immaturity and rostral sparing could increase the probability of developing Perthers' disease.

Legg‐Calvé‐Perthes Disease Produces Chronic Hip Synovitis and Elevation of Interleukin‐6 in the Synovial Fluid

  • N. KamiyaR. Yamaguchi H. Kim
  • Medicine, Biology
    Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research
  • 2015
In the active stage of LCPD, chronic hip synovitis and significant elevation of IL‐6 are produced in the synovial fluid, and IL‐1β and TNF‐α levels were not elevated.
...

References

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Evolution of Femoral Head Deformity During the Healing Phase of Legg‐Calvé‐Perthes Disease

The femoral head was more likely to undergo progressive flattening in older patients, in Those with more severe lateral pillar involvement, and in those with prolonged reossification.

Treatment of severe late-onset Perthes’ disease with soft tissue release and articulated hip distraction: revisited at skeletal maturity

A combination of soft tissue release and joint distraction with a hinged mono-lateral external fixator for these patients with late-onset Perthes’ disease is used as a salvage procedure.

Valgus femoral osteotomy for hinge abduction in Perthes' disease. Decision-making and outcomes.

Valgus osteotomy, with both rotational and sagittal correction, can improve symptoms, function and remodelling of the hip in patients with Perthes' disease.

A long-term follow-up of Legg-Calvé-Perthes disease.

In an effort to define the impairment in hips affected by Legg-Calvé-Perthes disease, we attempted to contact 112 patients whose disease had been diagnosed between 1920 and 1940. Data were available…

Evaluation and treatment of young adults with femoro-acetabular impingement secondary to Perthes' disease.

Hip pain and loss of motion in young adults with previous Legg-Calve-Perthes-Disease may be caused by anterior femoro-acetabular impingement, and correction of the femoral head/neck offset and treatment of the acetabular rim pathology was performed.

Legg-calve-perthes disease: a review of cases with onset before six years of age.

The prognosis for patients with the onset of Legg-Calvé-Perthes disease before the age of six years is favorable, with 80% having a good result.

Legg-Calvé-Perthes disease. The prognostic significance of the subchondral fracture and a two-group classification of the femoral head involvement.

A simple and practical two-group classification of the extent of involvement of the femoral head is proposed: Group A (less than half of the head) and Group B (more than half the head).

Lateral acetabular growth stimulation following a labral support procedure in Legg-Calve-Perthes disease.

Evaluating growth stimulation of the acetabulum in patients with unilateral Legg-Calvé-Perthes disease found beneficial effects of the labral support procedure are lateral acetabular growth stimulation, prevention of subluxation, and shelf resolution after femoral epiphyseal reossification.

Perthes' disease in the adolescent.

The poorest clinical results were found in the destructive type which was frequently associated with incapacitating pain requiring arthrodesis or excision arthroplasty within three years of onset of the disease.

Biomechanical properties of bone and cartilage in growing femoral head following ischemic osteonecrosis

Results indicate that the deterioration of the mechanical properties of the epiphyseal bone and cartilage likely plays a significant role in the pathogenesis of the femoral head deformity in LCPD.
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