eMedicine Specialties > Orthopedic Surgery > Hip

Legg-Calve-Perthes Disease: Follow-up

Author: George D Harris, MD, MS, Professor of Medicine, University of Missouri-Kansas City School of Medicine and Truman Medical Center at Lakewood
Contributor Information and Disclosures

Updated: Jan 27, 2009

Outcome and Prognosis

The prognosis for patients with Legg-Calvé-Perthes disease can be good and depends on the completeness of involvement of the epiphyseal center. The severity of involvement of the femoral head, its subsequent healing, and proper joint space preservation all determine the degree and timing for an athlete to participate in sports. The functional result depends on the amount of deformity that develops when the structure is softened. Overall, the prognosis for recovery and sports participation after treatment is very good for most individuals.

The patient's short-term prognosis is related to femoral head deformity at the completion of the healing stage. Risk factors include a clinical onset at an older age, extensive femoral epiphyseal involvement, femoral head containment, reduced range of motion in the hip, and premature closure of the growth plate.

The long-term prognosis is related to the potential for osteoarthritis of the hip as an adult. In patients with metaphyseal defects, in those in whom the disease develops late in childhood (age 10 y or older), and in those who have more complex involvement of the femoral head with residual deformity, the prognosis is worse, and degenerative arthritis occurs in nearly 100% of these patients. This rate is in comparison to those patients who are younger than 5 years when the problem develops. The incidence of degenerative arthritis is negligible in this younger population.

 


More on Legg-Calve-Perthes Disease

Overview: Legg-Calve-Perthes Disease
Workup: Legg-Calve-Perthes Disease
Treatment: Legg-Calve-Perthes Disease
Follow-up: Legg-Calve-Perthes Disease
Multimedia: Legg-Calve-Perthes Disease
References

References

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  2. Sales de Gauzy J, Briot J, Swider P. Coxa magna quantification using MRI in Legg-Calve-Perthes disease. Clin Biomech (Bristol, Avon). Jan 2009;24(1):43-6. [Medline].

  3. 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 Br. Oct 2008;90(10):1364-71. [Medline].

  4. Beer Y, Smorgick Y, Oron A, Mirovsky Y, Weigl D, Agar G, et al. Long-term results of proximal femoral osteotomy in Legg-Calvé-Perthes disease. J Pediatr Orthop. Dec 2008;28(8):819-24. [Medline].

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  9. Nowacki W, Szymkowiak E, Futyma J, Stencel P. A comparative analysis of conservative and surgical treatment of Perthes' disease. Ortop Traumatol Rehabil. 2004;6(6):748-50. [Medline].

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Further Reading

Keywords

LCPD, osteochondrosis of the femoral head, avascular necrosis of the proximal femoral head, intermittent limp, abductor lurch, painless limp, persistent hip pain, Trendelenburg gait

Contributor Information and Disclosures

Author

George D Harris, MD, MS, Professor of Medicine, University of Missouri-Kansas City School of Medicine and Truman Medical Center at Lakewood
George D Harris, MD, MS is a member of the following medical societies: American Academy of Family Physicians
Disclosure: Nothing to disclose.

Medical Editor

B Sonny Bal, MD, Associate Professor, Department of Orthopedic Surgery, University of Missouri School of Medicine
B Sonny Bal, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

James J McCarthy, MD, FAAOS, FAAP, Associate Professor, Consulting Orthopedic Surgeon, Department of Orthopedics and Rehabilitation, University of Wisconsin School of Medicine and Public Health;
James J McCarthy, MD, FAAOS, FAAP is a member of the following medical societies: Alpha Omega Alpha, American Academy for Cerebral Palsy and Developmental Medicine, American Academy of Orthopaedic Surgeons, American Academy of Pediatrics, American Orthopaedic Association, Limb Lengthening and Reconstruction Society ASAMI-North America, Orthopaedics Overseas, Pediatric Orthopaedic Society of North America, Pennsylvania Medical Society, Pennsylvania Orthopaedic Society, and Philadelphia County Medical Society
Disclosure: Nothing to disclose.

CME Editor

Dinesh Patel, MD, FACS, Associate Clinical Professor of Orthopedic Surgery, Harvard Medical School; Chief of Arthroscopic Surgery, Department of Orthopedic Surgery, Massachusetts General Hospital
Dinesh Patel, MD, FACS is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Association of Physicians of Indian Origin, American College of International Physicians, and American College of Surgeons
Disclosure: Nothing to disclose.

Chief Editor

Carlos J Lavernia, MD, FAAOS, Adjunct Clinical Professor, Department of Orthopedic Surgery, University of Miami School of Medicine; Medical Director, Orthopedic Institute at Mercy Hospital
Carlos J Lavernia, MD, FAAOS is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Association of Hip and Knee Surgeons, Arthritis Foundation, Biomedical Engineering Society, Florida Orthopaedic Society, and Orthopaedic Research Society
Disclosure: Zimmer Stock Implant Designer

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