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J Pediatr Orthop. 2008 Dec;28(8):819-24. doi: 10.1097/BPO.0b013e31818e122b.

Long-term results of proximal femoral osteotomy in Legg-Calvé-Perthes disease.

Author information

1
Department of Orthopedic Surgery, Schneider Children's Medical Center, Petah Tikva, Israel.

Abstract

BACKGROUND:

Legg-Calvé-Perthes disease is a childhood hip disorder that may result in a deformed and poorly functioning hip. The purpose of this study was to evaluate the correlation between hip deformity at skeletal maturity and degenerative osteoarthritis and to present the long-term results of proximal femoral varus derotational osteotomy in Legg-Calvé-Perthes disease.

METHODS:

We analyzed the results of 40 patients (43 hips), who underwent proximal femoral varus derotational osteotomy for Legg-Calvé-Perthes disease in our institution between 1959 and 1983. All available patients underwent a single long-term follow-up examination. Hips were classified with the classification system of Stulberg. Osteoarthritis was evaluated using the Tönnis classification. The long-term outcomes were evaluated after a mean follow-up period of 33 years.

RESULTS:

When examining the outcome using the Stulberg classification system, there were 8 Stulberg class I hips (19.5%), 15 Stulberg class II hips (36.6%), 8 Stulberg class III hips (19.5%), 9 Stulberg class IV hips (22%), and 1 Stulberg class V hip (2.4%). One patient, who had a bilateral Legg-Calvé-Perthes disease, underwent total hip replacement for osteoarthritis. Seven patients had poor clinical results.

CONCLUSIONS:

Proximal femoral varus derotational osteotomy provides good long-term results for Legg-Calvé-Perthes disease. The Stulberg classification is a good predictor for patient outcome.

LEVEL OF EVIDENCE:

Level IV, therapeutic study.

PMID:
19034171
DOI:
10.1097/BPO.0b013e31818e122b
[Indexed for MEDLINE]

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