Long-Term Results of Proximal Femoral Osteotomy in Legg-Calve-Perthes Disease.
Beer, Yiftah MD *; Smorgick, Yossi MD *; Oron, Amir MD *; Mirovsky, Yigal MD *; Weigl, Danny MD +; Agar, Gabriel MD *; Shitrit, Reuven MD ++; Copeliovitch, Leonel MD ++
Journal of Pediatric Orthopaedics.
28(8):819-824, December 2008.
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Background: Legg-Calve-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-Calve-Perthes disease.
Methods: We analyzed the results of 40 patients (43 hips), who underwent proximal femoral varus derotational osteotomy for Legg-Calve-Perthes disease in our institution between 1959 and1983. 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 Tonnis 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-Calve-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-Calve-Perthes disease. The Stulberg classification is a good predictor for patient outcome.
Level of Evidence: Level IV, therapeutic study.
(C) 2008 Lippincott Williams & Wilkins, Inc.