2,153 results match your criteria Legg-Calve-Perthes Disease


Subchondral fracture of the femoral head in children: Differential diagnosis of pediatric hip pain.

J Orthop Surg (Hong Kong) 2020 Jan-Apr;28(2):2309499020937862

Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

This report describes clinical and radiographic characteristics of two pediatric patients with a presumptive diagnosis of subchondral fracture of the femoral head made based on their clinical course and imaging findings. An 8-year-old boy and an 8-year-old girl had subchondral fracture in the femoral head without osteonecrosis, which was verified by contrast-enhanced magnetic resonance imaging. Although complete disappearance of the fracture line was confirmed in the boy, the girl had a residual femoral head deformity after conservative treatment. Read More

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http://dx.doi.org/10.1177/2309499020937862DOI Listing

A longitudinal study for the prediction of the mature acetabular morphology using childhood magnetic resonance imaging.

J Orthop Sci 2020 Jun 24. Epub 2020 Jun 24.

Department of Othopaedic and Spine Surgery, Fukuoka Children's Hospital, 5-1-1 Kashii Teriha, Higashi-ku, Fukuoka 812-0017, Japan.

Background: Although acetabular dysplasia is a common etiology of osteoarthritis of the hip regardless of the history of developmental dysplasia of the hip (DDH), whether or not corrective surgeries are beneficial for the childhood asymptomatic acetabular dysplasia remains controversial due to a lack of evidence. We conducted a longitudinal study to compare the cartilaginous morphology on childhood magnetic resonance imaging (MRI) and the mature hip morphology of the same patient and to assess the predictive indicators for future acetabular dysplasia.

Methods: A total of 92 unaffected hips (47 unilateral DDH and 45 unilateral Legg-Calvé-Perthes disease) were reviewed for X-ray and MRI findings on childhood (mean age: 6. Read More

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http://dx.doi.org/10.1016/j.jos.2020.05.002DOI Listing

A new anterior total hip arthroplasty reduction technique for patients who require leg lengthening.

Hip Int 2020 Jun 25:1120700020937248. Epub 2020 Jun 25.

Funabashi Orthopaedic Hospital, Funabashi, Chiba, Japan.

Background: When performing anterior total hip arthroplasty (THA) for patients who require leg lengthening, surgeons often encounter difficulties during reduction due to soft tissue tightness. The purpose of this study was to introduce a new THA reduction technique for these patients.

Methods: Between October 2018 and September 2019, 545 THAs were performed. Read More

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http://dx.doi.org/10.1177/1120700020937248DOI Listing

The Effect of Clinical Knowledge and Surgical Experience on Treatment Choice in Legg-Calve-Perthes Disease: Intra-observer and Inter-observer Reliability Study.

Indian J Orthop 2020 Jul 10;54(4):477-485. Epub 2020 Feb 10.

Ege University School of Medicine ARGEFAR, Izmir, Turkey.

Aim: The aim of this study was to evaluate standardized hip radiographs, arthographs, demographic characteristics, physical examination findings, and their effects on treatment choices in leg-calve-perthes disease (LCPD). Intraobserver and interobserver realibility between orthopaedic residents, orthopaedic surgeons, and paediatric orthopaedic surgeons were also investigated.

Materials And Methods: 47 LCPD patients were included this cross-sectional study. Read More

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http://dx.doi.org/10.1007/s43465-020-00047-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7270382PMC

Ellipsoidal process of the femoral head in Legg-Calvé-Perthes disease. Part I.

J Pediatr Orthop B 2020 Jun 2. Epub 2020 Jun 2.

Hospital Universitario Niño Jesús.

Background: Legg-Calvé-Perthes disease (LCPD) often produces a residual deformity, typically consistent with coxa magna, coxa plana, and ellipsoidal shape. Depending on the degree of asphericity and flatness, this morphology was classified by Stulberg in stages III and IV. Thus far, few studies have investigated physeal injury as an etiological cause or evaluated its progressive profile throughout Waldenström's reossification stage and the remodelling stage. Read More

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http://dx.doi.org/10.1097/BPB.0000000000000748DOI Listing

The acetabulum in healed Legg-Calvé-Perthes disease is cranially retroverted and associated with global reduction of femoral head coverage: a matched-cohort study.

J Hip Preserv Surg 2020 Jan 7;7(1):49-56. Epub 2020 Feb 7.

Department of Orthopedic Surgery, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA.

To evaluate the acetabular morphology in healed Legg-Calvé-Perthes disease after skeletal maturity using computed tomography (CT) scan and to compare with matched controls. We identified 33 (37 hips) patients with healed Legg-Calvé-Perthes disease and closed triradiate cartilage who underwent pelvic CT scan. Each patient was matched based on sex, age and side to a subject with no history of hip disease who had undergone pelvic CT evaluation because of abdominal pain. Read More

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http://dx.doi.org/10.1093/jhps/hnaa003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7195929PMC
January 2020

The outcomes of Perthes' disease.

Bone Joint J 2020 May;102-B(5):611-617

University of Liverpool, Liverpool, UK.

Aims: To identify a suite of the key physical, emotional, and social outcomes to be employed in clinical practice and research concerning Perthes' disease in children.

Methods: The study follows the guidelines of the COMET-Initiative (Core Outcome Measures in Effectiveness Trials). A systematic review of the literature was performed to identify a list of outcomes reported in previous studies, which was supplemented by a qualitative study exploring the experiences of families affected by Perthes' disease. Read More

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http://dx.doi.org/10.1302/0301-620X.102B5.BJJ-2020-0072DOI Listing

Top Ten Adult Manifestations of Childhood Hip Disorders: An Up-To-Date Review for General Radiologists.

Radiol Clin North Am 2020 May;58(3):529-548

Department of Imaging Sciences, Strong Memorial Hospital, Box 648, 601 Elmwood Avenue, Rochester, NY 14642, USA.

Congenital, developmental, and acquired conditions of the pediatric hip frequently present with sequelae in the adult. There is substantial overlap in the end-stage results of these pathologic conditions, including osseous changes, chondral/labral injuries, and premature osteoarthritis. This review discusses the top 10 etiopathogeneses of pediatric hip conditions and presents associated dysmorphisms in the adult on an illustrative, multimodality, case-based template. Read More

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http://dx.doi.org/10.1016/j.rcl.2020.01.002DOI Listing

Viewing arthrography images affects treatment preferences for Legg-Calvé-Perthes disease among medical professionals.

J Orthop 2020 Sep-Oct;21:94-99. Epub 2020 Mar 25.

Department of Orthopaedics and Traumatology, Tepecik Training and Research Hospital, İzmir, Turkey.

Objectives: We explored how experience of arthrography affects treatment preferences for Legg-Calvé-Perthes disease (LCPD) patients. We also examined changes in surgical procedure preferences after examining arthrography images. In addition, we analysed the effect of experience with arthrography on treatment and surgical modality preferences. Read More

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http://dx.doi.org/10.1016/j.jor.2020.03.012DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7114729PMC

Semantic segmentation of the multiform proximal femur and femoral head bones with the deep convolutional neural networks in low quality MRI sections acquired in different MRI protocols.

Comput Med Imaging Graph 2020 Apr 5;81:101715. Epub 2020 Mar 5.

Department of Orthopaedics and Traumatology, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey. Electronic address:

Medical image segmentation is one of the most crucial issues in medical image processing and analysis. In general, segmentation of the various structures in medical images is performed for the further image analyzes such as quantification, assessment, diagnosis, prognosis and classification. In this paper, a research study for the 2D semantic segmentation of the multiform, both spheric and aspheric, femoral head and proximal femur bones in magnetic resonance imaging (MRI) sections of the patients with Legg-Calve-Perthes disease (LCPD) with the deep convolutional neural networks (CNNs) is presented. Read More

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http://dx.doi.org/10.1016/j.compmedimag.2020.101715DOI Listing

Global differences in the treatment of Legg-Calvé-Perthes disease: a comprehensive review.

Arch Orthop Trauma Surg 2020 Mar 14. Epub 2020 Mar 14.

Department of Orthopedics, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria.

Introduction: Global discussions regarding the treatment of Legg-Calvé-Perthes disease (LCPD) are still controversial. The aim of this study was to characterize the worldwide regional differences in nonoperative and operative treatment for LCPD.

Materials And Methods: Based on a comprehensive literature search, 123 studies describing the results of nonoperative and operative treatment for LCPD were included. Read More

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http://dx.doi.org/10.1007/s00402-020-03392-9DOI Listing

Evolution of Legg-Calvé-Perthes disease following proximal femoral varus osteotomy performed in the avascular necrosis stage:a prospective study.

J Child Orthop 2020 Feb;14(1):58-67

Scottish Rite Hospital for Children, Department of Orthopaedic Surgery, UT Southwestern Medical Center, Dallas, Texas, United States.

Purpose: This prospective study was undertaken to describe patterns of fragmentation of the femoral epiphysis following a proximal femoral varus osteotomy (PFVO) done during stage I of LCPD and to assess the disease duration and outcome in each pattern.

Methods: A total of 25 children treated by a PFVO in stage I of LCPD were followed until healing. The MRI Perfusion Index, radiographic changes in the femoral epiphysis, disease duration and the Sphericity Deviation Score (SDS) at healing were documented. Read More

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http://dx.doi.org/10.1302/1863-2548.14.190153DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7043118PMC
February 2020

Development of a novel minimally invasive technique to washout necrotic bone marrow content from epiphyseal bone: A preliminary cadaveric bone study.

Orthop Traumatol Surg Res 2020 Jun 4;106(4):709-715. Epub 2020 Mar 4.

Center for Excellence in Hip Disorders, Texas Scottish Rite Hospital, 75219 Dallas, TX, USA; Department of Orthopedic Surgery, University of Texas Southwestern Medical Center at Dallas, 75390 Dallas, TX, USA. Electronic address:

Introduction: Legg-Calvé-Perthes disease is a juvenile ischemic osteonecrosis which produces extensive necrotic cell debris and release of damage associated molecular patterns (DAMPs) in the femoral head. The necrotic bone environment induces a chronic inflammatory repair response with excessive bone resorption leading to deformity and early osteoarthritis. Currently there is no minimally invasive method to clear the necrotic materials from the bone to decrease the inflammatory burden of the necrotic environment and to improve the healing process. Read More

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http://dx.doi.org/10.1016/j.otsr.2020.01.006DOI Listing
June 2020
1.168 Impact Factor

Influence of passive smoking on the onset of Legg-Calvè-Perthes disease: a systematic review and meta-analysis.

J Pediatr Orthop B 2020 Mar 4. Epub 2020 Mar 4.

The Third Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China.

The relationship between passive smoking and the onset of Legg-Calvè-Perthes disease is still controversial. Therefore, we concluded the study to systematically evaluate and analyze the relationship. A comprehensive search was conducted. Read More

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http://dx.doi.org/10.1097/BPB.0000000000000725DOI Listing

A Comparison of Transphyseal Neck-Head Tunneling and Multiple Epiphyseal Drilling on Femoral Head Healing Following Ischemic Osteonecrosis: An Experimental Investigation in Immature Pigs.

J Pediatr Orthop 2020 Apr;40(4):168-175

Department of Orthopaedics, Texas Scottish Rite Hospital for Children, Center for Excellence in Hip Disorders, University of Texas Southwestern Medical Center, TX.

Background: Two operative procedures are currently advocated to stimulate the necrotic femoral head healing in children with Legg-Calve-Perthes disease: transphyseal neck-head tunneling (TNHT) and multiple epiphyseal drilling (MED). The purpose of this study was to compare the bone healing and physeal function after treatment with TNHT or MED in a piglet model of ischemic osteonecrosis.

Methods: Eighteen piglets were induced with osteonecrosis by surgically placing a ligature tightly around the right femoral neck. Read More

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http://dx.doi.org/10.1097/BPO.0000000000001219DOI Listing

Functional Outcomes of Hip Arthroscopy for Pediatric and Adolescent Hip Disorders.

Clin Orthop Surg 2020 Mar 13;12(1):94-99. Epub 2020 Feb 13.

Division of Pediatric Orthopaedics, Seoul National University Children's Hospital, Seoul, Korea.

Background: There is a paucity of literature on the use of hip arthroscopy for pathologic conditions in skeletally immature patients. Thus, the indications and safety of the procedure are still unclear. The purpose of this study was to investigate the safety and functional outcomes of hip arthroscopy for pediatric and adolescent hip disorders. Read More

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http://dx.doi.org/10.4055/cios.2020.12.1.94DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7031430PMC

Long-term follow-up results of femoral varus osteotomy in the treatment of Perthes disease, and comparison of open-wedge and closed-wedge osteotomy techniques: A retrospective observational study.

Authors:
Atilla Citlak

Medicine (Baltimore) 2020 Feb;99(7):e19041

In this retrospective observational study, I aimed to report long-term follow-up results of femoral varus osteotomy in the treatment of Perthes disease patients who were between 6 and 8 years old at the onset of the disease with Herring B and C hip involvement. I also aimed to compare 2 different osteotomy techniques: open-wedge and closed-wedge femoral varus osteotomies.Patients with Perthes disease treated with femoral varus osteotomies were invited for final examination. Read More

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http://dx.doi.org/10.1097/MD.0000000000019041DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7035022PMC
February 2020

Open Reduction and Internal Fixation for the Treatment of Symptomatic Osteochondritis Dissecans of the Femoral Head in Patients With Sequelae of Legg-Calvé-Perthes Disease.

J Pediatr Orthop 2020 Mar;40(3):120-128

Department of Orthopaedic Surgery, Washington University, St Louis, MO.

Background: Osteochondritis dissecans (OCD) is estimated to occur in 2% to 7% of patients with Legg-Calvé-Perthes disease (LCPD). Unstable osteochondral fragments secondary to LCPD may produce mechanical symptoms requiring surgical intervention. Reattachment of the fragment with open reduction and internal fixation (ORIF) may provide good clinical outcomes. Read More

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http://dx.doi.org/10.1097/BPO.0000000000001192DOI Listing

Developmental Dysplasia of the Hip with Concurrent Legg-Calvé-Perthes Disease in the Contralateral Hip.

Cureus 2019 Dec 28;11(12):e6494. Epub 2019 Dec 28.

Orthopaedics, King Saud Bin Abdulaziz University for Health Sciences / College of Medicine, Jeddah, SAU.

Developmental dysplasia of the hip (DDH) is a common hip disorder in pediatrics; about one in 100 newborns has it due to dysplasia and one to two per 1000 have it due to dislocation. Some factors are responsible for the disease, and breech presentation has been identified as a major risk factor. It might be associated with other conditions too. Read More

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http://dx.doi.org/10.7759/cureus.6494DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6984184PMC
December 2019

Legg-Calve-Perthes Disease: Correlation between Computed Radiography and Magnetic Resonance Imaging.

Mymensingh Med J 2020 Jan;29(1):55-59

Dr Neli Rubyat Sanzida Banu, Assistant Professor (Radiology & Imaging), Mymensingh Medical College (MMC), Mymensingh, Bangladesh.

The purpose of this study is to diagnose Legg-Calve-Perthes disease by computed radiography and Magnetic resonance imaging and accurate staging and correlating the findings of these two modalities. Thirty five (35) patients complaining pain in groins and painful walking, after thorough physical examinations were sent to Department of Radiology & Imaging, Mymensingh Medical College Hospital, Mymensingh, Bangladesh for computed radiography and Magnetic Resonance Imaging examination. This cross sectional study was conducted in the Department of Radiology, Mymensingh Medical College Hospital, Mymensingh, Bangladesh from July 2016 to June 2018. Read More

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January 2020

Outcome after osteochondroplasty and relative neck lengthening for patients with healed Legg-Calvé-Perthes disease: a retrospective cohort study of patients with hip-deformities treated with osteochondroplasty and relative neck lengthening.

Hip Int 2019 Dec 26:1120700019896767. Epub 2019 Dec 26.

Department of Orthopaedics, Sheffield Children's Hospital, Sheffield, UK.

Aims: Our main objectives were to evaluate the effect of surgery using self-assessed health scores. Secondary objectives were to correlate outcome with grade of deformity (Stulberg classification I-V) or age at surgery and whether additional periacetabular osteotomy (PAO) is beneficial for patients with concurrent acetabular dysplasia.

Methods: This was a retrospective cohort and in part a cross sectional study using a planned clinical and radiological follow-up of patients. Read More

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http://dx.doi.org/10.1177/1120700019896767DOI Listing
December 2019

Comparison of surgical and nonsurgical containment methods for patients with Legg-Calvé-Perthes disease of the onset ages between 6.0 and 8.0 years: Salter osteotomy versus a non-weight-bearing hip flexion-abduction brace.

J Pediatr Orthop B 2019 Dec 14. Epub 2019 Dec 14.

Department of Orthopaedic Surgery, Aichi Prefectural Mikawa Aoitori Medical and Rehabilitation Center for Developmental Disabilities, Okazaki, Aichi, Japan.

Since bone healing potential decreases with age, patients with Legg-Calvé-Perthes disease should receive treatment appropriate to their age group. Nonsurgical treatment is commonly applied to patients under 6.0 years of age at the onset and surgical treatment is recommended for those over 8. Read More

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http://dx.doi.org/10.1097/BPB.0000000000000710DOI Listing
December 2019

CORR Insights®: Isolated Trochanteric Descent and Greater Trochanteric Apophyseodesis Are Not Effective in the Treatment of Post-Perthes Deformity.

Clin Orthop Relat Res 2020 01;478(1):176-178

A. Grzegorzewski, Medical University of Lodz, Department of Orthopaedics and Pediatric Orthopaedics, Lodz, Poland.

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http://dx.doi.org/10.1097/CORR.0000000000001057DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7000067PMC
January 2020

Pediatric Hip and Pelvis.

Pediatr Clin North Am 2020 02;67(1):139-152

Seaview Orthopaedic & Medical Associates, 1200 Eagle Avenue, Ocean, NJ 07712, USA. Electronic address:

The most common pediatric orthopedic conditions of the hip and pelvis involve abnormal architecture of the joint leading to pain and dysfunction. Developmental dysplasia of the hip and femoroacetabular impingement are 2 common and distinct forms of structural pathology in the pediatric hip. The authors also discuss 2 of the more common, and often questioned, pediatric hip disorders-slipped capital femoral epiphysis and Legg-Calvé-Perthes disease. Read More

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http://dx.doi.org/10.1016/j.pcl.2019.09.003DOI Listing
February 2020

Association of IL-6 -174G > C and -572G > C Polymorphisms with Risk of Legg-Calve-Perthes Disease in Iranian Children.

Fetal Pediatr Pathol 2019 Nov 22:1-8. Epub 2019 Nov 22.

Mother and Newborn Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

Legg-Calve-Perthes disease (LCPD) is an idiopathic avascular necrosis of the capital femoral epiphysis of the femoral head with multifactorial etiology. The aim of this study was to analyze the association of IL-6 polymorphisms with LCPD risk in Iranian children. The study comprised of 45 children diagnosed with LCPD and 60 healthy subjects. Read More

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http://dx.doi.org/10.1080/15513815.2019.1693671DOI Listing
November 2019
0.398 Impact Factor

Isolated Trochanteric Descent and Greater Trochanteric Apophyseodesis Are Not Effective in the Treatment of Post-Perthes Deformity.

Clin Orthop Relat Res 2020 01;478(1):169-175

J. Haskel, O. Feder, P. Castañeda, NYU Langone Orthopedic Hospital, New York, NY, USA J. Mijares, Shriners Hospital for Children, Mexico City, Mexico.

Background: Greater trochanteric apophyseodesis and isolated trochanteric descent seek to prevent abductor weakness in patients with a hip deformity because of Legg-Calvé-Perthes disease; however, no studies have evaluated radiographic findings or abductor strength in children treated with these procedures.

Questions/purposes: (1) Do children with Waldenström Stage III Legg-Calvé-Perthes disease treated with either isolated greater trochanteric descent or isolated greater trochanteric apophyseodesis achieve improved radiographic findings (Stulberg classification or neck-shaft angle) compared with those who underwent no surgical treatment? (2) Do children treated with one of those procedures achieve greater abductor strength than those who did not have surgery?

Methods: Between 2006 and 2010, we treated 89 children with Waldenström Type III Legg-Calvé-Perthes disease (reossification). Of these, 27. Read More

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http://dx.doi.org/10.1097/CORR.0000000000000990DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7000034PMC
January 2020

[The limping child: a red flag for every physician].

Ned Tijdschr Geneeskd 2019 10 24;163. Epub 2019 Oct 24.

Amphia Ziekenhuis, Afd. Kinderorthopedie, Breda.

A limping gait pattern in a child is a red flag for every physician until proven otherwise. Among the most common causes are coxitis fugax, infection (septic arthritis, osteomyelitis), Perthes disease, and slipped capital femoral epiphysis, depending on the age of the patient. A high index of suspicion is required because clinical findings are often subtle, and the diagnosis may be present even if initial radiographs are negative. Read More

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October 2019

Compensatory sagittal plane ankle gait mechanics: Are they present in patients with a weak or stiff hip?

Gait Posture 2019 10 20;74:250-254. Epub 2019 Sep 20.

Texas Scottish Rite Hospital for Children, Dallas, TX, USA.

Introduction: Simulations suggest that subjects with reduced hip range of motion (ROM) and/or weakness can achieve more normal walking mechanics through compensations at the ankle. The aims of this study were to assess whether subjects with reduced hip ROM (Stiff hip) or hip flexor weakness (Weak hip) exhibit ankle compensations during walking and investigate redistribution of power in the lower extremity joints.

Methods: Retrospective gait data were reviewed (IRB-approved hip registry). Read More

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http://dx.doi.org/10.1016/j.gaitpost.2019.09.018DOI Listing
October 2019

Severe bilateral Legg-Calvé-Perthes resolved with pamidronate in combination with casts, physiotherapy and adductor tenotomy: a pictorial essay over 11 years.

BMJ Case Rep 2019 Sep 18;12(9). Epub 2019 Sep 18.

Pediatric Rheumatology, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada.

We describe an 11-year prospective clinical and radiologic course of a 6-year-old boy with bilateral Legg-Calvé-Perthes disease, who was treated with intravenous pamidronate (IV-PAM). His baseline radiographs showed grade IV avascular necrosis/Catterall stage IV, and at worst he progressed to lateral pillar/Herring stage C bilaterally. His disease initially was extremely functionally limiting with expected poor outcome with eventual joint replacement. Read More

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http://dx.doi.org/10.1136/bcr-2019-229919DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6754667PMC
September 2019
7 Reads

[Long-term outcomes of Chiari osteotomy for Legg-Calvé-Perthes disease in children].

Zhongguo Gu Shang 2019 Aug;32(8):696-700

Department of Orthopaedics, the First Hospital of Jilin University, Changchun 130021, Jilin, China;

Objective: To explore long-term outcomes of Chiari osteotomy for Legg-Calvé-Perthes disease in children with type Catterall III or IV, and to analyze clinical effect of osteotomy angle on clinical and radiographic results.

Methods: From March 2005 to July 2013, 26 children with Legg-Calvé-Perthes disease with type Catterall III or IV were treated by Chiari osteotomy, including 17 males and 9 females, aged from 4 to 13 years old with an average of (8.9±2. Read More

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http://dx.doi.org/10.3969/j.issn.1003-0034.2019.08.004DOI Listing
August 2019
4 Reads

Does Early Proximal Femoral Varus Osteotomy Shorten the Duration of Fragmentation in Perthes Disease? Lessons From a Prospective Multicenter Cohort.

J Pediatr Orthop 2020 May/Jun;40(5):e322-e328

Texas Scottish Rite Hospital for Children.

Background: The prognosis of Legg-Calvé-Perthes disease (LCPD) is dependent upon several factors, with the length and severity of the fragmentation stage among the most important. Previous retrospectively collected data from a single center have suggested that early proximal femoral varus osteotomy (PFO) may shorten the length of fragmentation and allow 34% of patients to bypass fragmentation altogether resulting in less femoral head deformity. The purpose of this study was to validate these findings in a prospectively collected multicenter cohort. Read More

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http://dx.doi.org/10.1097/BPO.0000000000001451DOI Listing
September 2019
2 Reads

Anterolateral Approach in the Treatment of Femoroacetabular Impingement of the Hip.

Clin Orthop Surg 2019 09 12;11(3):337-343. Epub 2019 Aug 12.

Department of Orthopedic Surgery, Pediatric Orthopedics and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.

Background: Ganz surgical hip dislocation via a posterior (Kocher-Langenbeck) approach is a popular procedure in the management of femoroacetabular impingement (FAI). We report the results of surgery performed through an anterolateral (Watson-Jones) approach in the management of anterolateral FAI.

Methods: Twenty-one hips in 20 patients (mean age at the time of operation, 17. Read More

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http://dx.doi.org/10.4055/cios.2019.11.3.337DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6695336PMC
September 2019
1 Read

Secondary hip dysplasia increases risk for early coxarthritis after Legg-Calve-Perthes disease. A study of 255 hips.

Comput Methods Biomech Biomed Engin 2019 Nov 20;22(14):1107-1115. Epub 2019 Aug 20.

Department of Orthopaedic Surgery, University Medical Centre Ljubljana , Ljubljana , Slovenia.

The biomechanical parameters of the hip joint articular surface were analysed in 141 adult hips after Legg-Calve Perthes Disease, and 114 contralateral unaffected hips (controls), by using HIPSTRESS mathematical models. Geometrical parameters, assessed from anteroposterior and axial radiograms, were used as input to models for resultant hip force and contact hip stress. Results confirm previous indications that head enlargement after the Legg-Calve-Perthes Disease compensates the values of hip stress. Read More

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http://dx.doi.org/10.1080/10255842.2019.1634193DOI Listing
November 2019
7 Reads

[Perfusion magnetic resonance imaging in the treatment of Perthes disease].

Ugeskr Laeger 2019 Jul;181(30)

In this review about perfusion magnetic resonance imaging (pMRI), we consider it to give detailed insight into the distribution of the infarction in the femoral head in the early phase of Perthes disease. The degree of head involvement is closely related to the long-term prognosis, and as early surgical treatment of children with severe head involvement may be beneficial, pMRI is suggested as an examination in older children with early stages of Perthes disease. The use of gadolinium as contrast medium in otherwise healthy children seems safe, but long-term effects are unknown. Read More

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Validation of Pediatric Self-Report Patient-Reported Outcomes Measurement Information System (PROMIS) Measures in Different Stages of Legg-Calvé-Perthes Disease.

J Pediatr Orthop 2020 May/Jun;40(5):235-240

Texas Scottish Rite Hospital for Children.

Objectives: Patient-reported outcomes (PRO) assessing health-related quality of life (HRQoL) are important outcome measures, especially in Legg-Calvé-Perthes disease (LCPD) where symptoms (pain and limping), activity restrictions, and treatments vary depending on the stage of the disease. The purpose of this study was to investigate the validity of the Patient-reported Outcomes Measurement Information System (PROMIS) for measuring HRQoL of patients with LCPD in various stages of the disease.

Methods: This is a multicenter validity study. Read More

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http://dx.doi.org/10.1097/BPO.0000000000001423DOI Listing
July 2019
12 Reads

Innominate Salter osteotomy using resorbable screws: a retrospective case series and presentation of a new concept for fixation.

J Child Orthop 2019 Jun;13(3):310-317

Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden.

Purpose: The Salter innominate osteotomy (SIO) in children is traditionally stabilized by Kirschner-wires, which have issues regarding stability, infection and the need to be extracted. To counter these disadvantages, we present a surgical method to stabilize SIO with modern resorbable poly lactic-co-glycolic acid screws. Using a case series of 21 patients treated with SIO for developmental dysplasia of the hip or Legg-Calvé-Perthes disease we evaluate the feasibility of the method. Read More

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http://dx.doi.org/10.1302/1863-2548.13.180195DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6598047PMC
June 2019
1 Read

Greater Trochanter Apophysiodesis in Legg-Calve-Perthes Disease: Which Implant to Choose?

Indian J Orthop 2019 Jul-Aug;53(4):548-553

Baltalimani Bone Diseases Education and Training Hospital, Department of Pediatric Orthopaedic Surgery, Istanbul, Turkey.

Background: Greater trochanter apophysiodesis (GTA) is relatively minimal invasive technique for the treatment of trochanteric overgrowth. Various types of implants can be used in each procedure. The purpose of this study was to compare outcomes of three different types of implants that were used in treatment of trochanteric overgrowth in Legg-Calve-Perthes disease. Read More

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http://dx.doi.org/10.4103/ortho.IJOrtho_166_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6590009PMC
July 2019
1 Read

Estimation of Femoral Neck Anteversion in Adults: A Comparison Between Clinical Method, Radiography, and Computed Tomography at a Tertiary-care Center in Eastern India.

Cureus 2019 Apr 16;11(4):e4469. Epub 2019 Apr 16.

Orthopaedics, All India Institute of Medical Sciences, Bhubaneswar, IND.

Introduction Femoral anteversion is the anterior inclination of the femoral neck and head in relation to the shaft of the femur. Femoral anteversion provides torsional stability of the hip - an important clinical factor for conditions such as trauma, arthroplasty, developmental dysplasia of the hip, and Legg-Calve Perthes disease. Precise measurement is important to avoid instability in pathological conditions of the hip. Read More

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http://dx.doi.org/10.7759/cureus.4469DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6579354PMC
April 2019
7 Reads

Hip resurfacing arthroplasty for end-stage arthritis caused by childhood hip disease.

Hip Int 2019 Jun 23:1120700019858728. Epub 2019 Jun 23.

2 Midlands Orthopaedics, Columbia, SC, USA.

Introduction: Patients with hip arthritis due to Legg-Calvé-Perthes (LCP) and slipped capital femoral epiphysis (SCFE) pose altered femoral anatomy, making hip resurfacing arthroplasty (HRA) technically complicated. We examined implant survival and clinical symptoms in patients with a history of LCP or SCPE who underwent HRA for end-stage osteoarthritis.

Methods: Data was collected for patients who underwent HRA for osteoarthritis due to LCP ( 59) or SCFE ( 32). Read More

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http://journals.sagepub.com/doi/10.1177/1120700019858728
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http://dx.doi.org/10.1177/1120700019858728DOI Listing
June 2019
9 Reads

The role and underlying mechanisms of microRNA‑214 in Legg‑Calvé‑Perthes disease.

Mol Med Rep 2019 Jul 22;20(1):685-692. Epub 2019 May 22.

Department of Orthopedics, Children's Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu 210009, P.R. China.

Legg‑Calvé‑Perthes disease (LCPD) is a pediatric form of femoral head osteonecrosis with unknown etiology. MicroRNAs (miRs) have been revealed to serve an important role in LCPD. MiR‑214 serves an important role in chondrogenesis. Read More

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http://dx.doi.org/10.3892/mmr.2019.10271DOI Listing
July 2019
6 Reads

Mobility and leg ulceration: a case study.

Authors:
Sylvie Hampton

Br J Community Nurs 2019 Jun;24(Sup6):S42

Independent Tissue Viability Consultant, Director of Wound Care Consultancy Ltd.

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http://dx.doi.org/10.12968/bjcn.2019.24.Sup6.S42DOI Listing
June 2019
1 Read

Direct Lateral Approach for Triple Pelvic Osteotomy.

J Am Acad Orthop Surg 2020 Jan;28(2):e64-e70

From the Department of Orthopedic Surgery, Loma Linda University Medical Center, Loma Linda, CA (Dr. Grigoryan, Dr. Korcek, and Dr. Nelson); the Department of Orthopedic Surgery, Rambam Academic Hospital, Haifa, Israel (Dr. Eidelman); and the Paley Orthopedic and Spine institute At Saint Mary's Medical Center, West Palm Beach, FL (Dr. Paley).

Introduction: Triple pelvic osteotomy (TPO) involves periacetabular osteotomies of the ilium, ischium, and pubis to reorient the acetabulum. This operation is indicated in certain situations for the treatment of developmental dysplasia of the hip, dysplastic neuromuscular hips, and for containment of the femoral head in cases of Legg-Calvé-Perthes disease.

Methods: This retrospective cohort study compares radiographic outcomes of patients who underwent TPO using two different techniques and describes a novel single-incision direct lateral approach. Read More

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http://Insights.ovid.com/crossref?an=00124635-900000000-9935
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http://dx.doi.org/10.5435/JAAOS-D-16-00918DOI Listing
January 2020
11 Reads

Using a 3D Printed Model as a Preoperative Tool for Pelvic Triple Osteotomy in Children: Proof of Concept and Evaluation of Geometric Accuracy.

J Am Acad Orthop Surg Glob Res Rev 2019 Mar 19;3(3):e074. Epub 2019 Mar 19.

Department of Orthopedics (Dr. Hedelin and Dr. Laine), Sahlgrenska University Hospital, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg; Department of Medical Physics and Technology (Dr. Swinkels), Sahlgrenska University Hospital; Department of Radiology (Dr. Mack), Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg; Department of Radiation Physics (Dr. Lagerstrand), Institute of Clinical Sciences, The Sahlgrenska Academy at University of Gothenburg; and Department of Medical Physics and Technology (Dr. Lagerstrand), Sahlgrenska University Hospital, Gothenburg, Sweden.

The feasibility of 3D printing in clinical practice depends not only on the usability but also on the reliability of the method. The aims of this study were to demonstrate the feasibility of a 3D printing method for pediatric patients planned for pelvic triple osteotomy and to present a reliable quality assessment strategy for these printed models. A 10-year-old boy with Legg-Calvé-Perthes disease underwent a triple pelvic osteotomy. Read More

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http://dx.doi.org/10.5435/JAAOSGlobal-D-18-00074DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6484673PMC
March 2019
5 Reads

[Perthes disease-news in diagnostics and treatment].

Orthopade 2019 Jun;48(6):515-522

Orthopädische Klinik, Universitätsklinikum Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Deutschland.

Diagnostics: Perthes disease remains a challenge for paediatric orthopedic surgeons. X‑ray imaging is still the method of choice for diagnostics and follow-up examination. A more detailed differentiation of Waldenström's classification, especially in early and late fragmentation stages, might be relevant to optimize timing of containment surgery. Read More

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http://dx.doi.org/10.1007/s00132-019-03737-2DOI Listing
June 2019
7 Reads

A new scheme for automatic 2D detection of spheric and aspheric femoral heads: A case study on coronal MR images of bilateral hip joints of patients with Legg-Calve-Perthes disease.

Comput Methods Programs Biomed 2019 Jul 1;175:83-93. Epub 2019 Apr 1.

Department of Orthopaedics and Traumatology, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey.

Background And Objective: In orthopaedics, hip joint and circular structure of the femoral head can be distorted by a wide variety of hip joint disorders. Hence, automatic detection and segmentation of the femoral head is an important issue in the studies of computerized hip joint segmentation, quantification and assessment. In the proposed study, we need to detect the center coordinates and radius of spheric and aspheric femoral heads automatically in bilateral hip magnetic resonance (MR) images using a new scheme. Read More

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http://dx.doi.org/10.1016/j.cmpb.2019.04.001DOI Listing
July 2019
3 Reads

Natural History of the Dysplastic Hip Following Modern Periacetabular Osteotomy.

J Bone Joint Surg Am 2019 May;101(10):932-938

Department of Orthopedic Surgery (C.C.W., J.S.V., M.J.H., R.T.T., and R.J.S.) and Division of Biomedical Statistics and Informatics (K.C.M.), Mayo Clinic, Rochester, Minnesota.

Background: Periacetabular osteotomy (PAO) is the most common treatment for symptomatic acetabular dysplasia, or developmental dysplasia of the hip (DDH), in skeletally mature patients. The purpose of this multicenter cohort study was to delineate the long-term radiographic natural history of the dysplastic hip following PAO.

Methods: We evaluated all patients undergoing PAO from 1996 to 2012 at 3 academic institutions in the United States. Read More

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http://Insights.ovid.com/crossref?an=00004623-201905150-0000
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http://dx.doi.org/10.2106/JBJS.18.00983DOI Listing
May 2019
20 Reads

Apophysitis and Osteochondrosis: Common Causes of Pain in Growing Bones.

Am Fam Physician 2019 05;99(10):610-618

Fairview Sports and Orthopedic Care, Blaine, MN, USA.

Apophysitis and osteochondrosis are common causes of pain in growing bones but have differing etiologies and required management. Apophysitis results from a traction injury to the cartilage and bony attachment of tendons in children and adolescents. Most often it is an overuse injury in children who are growing and have tight or inflexible muscle tendon units. Read More

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May 2019
9 Reads

The possible origin of Legg-Calvé-Perthes disease

Rev Med Inst Mex Seguro Soc 2019 Apr 1;57(1):36-41. Epub 2019 Apr 1.

Universidad Autónoma Metropolitana, Unidad Xochimilco, Licenciatura en Medicina, Departamento de Atención a la Salud. Ciudad de México, México

Legg-Calvé-Perthes disease (LCPD) is a childhood orthopedic pathology that affects the development of the hip. It is a rare disease with a huge variation in annual incidence. It occurs approximately five times more often in boys than in girls. Read More

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April 2019
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Analysis of Trabecular Microstructure and Vascular Distribution of Capital Femoral Epiphysis Relevant to Legg-Calve-Perthes Disease.

J Orthop Res 2019 08 25;37(8):1784-1789. Epub 2019 Apr 25.

Center for Excellence in Hip Disorders, Texas Scottish Rite Hospital for Children, Dallas, Texas.

Legg-Calve-Perthes disease is characterized by the capital femoral epiphyseal collapse, which occurs more reliably in the anterior quadrant than the more weight-bearing lateral quadrant. The purpose of this study was to determine whether there is a vascular or microstructural predisposition for anterior femoral epiphyseal collapse in Perthes disease. Thirty-two cadaveric proximal femoral epiphyses from 17 subjects (age 4-14 years old) underwent micro-computed tomography at 10-μm resolution. Read More

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http://dx.doi.org/10.1002/jor.24311DOI Listing
August 2019
8 Reads