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Acta Orthop Traumatol Turc 2019 Jan 29. Epub 2019 Jan 29.

Acıbadem University, School of Medicine, Istanbul, Turkey.

The deformed and enlarged femoral head secondary to hip diseases such as Legg Calve Perthes and Developmental Dysplasia usually causes impingement between the aspherical head and the acetabulum. To restore and reduce the size of enlarged femoral head, a femoral head reduction technique has been described previously. The goal is to obtain a spherical femoral head and to cover the gliding surface with best available cartilage. Read More

Clin Orthop Relat Res 2019 Jan 7. Epub 2019 Jan 7.

Department of Orthopaedic Surgery, Inselspital Bern, University of Bern, Bern, Switzerland.

Background: Correct quantification of femoral torsion is crucial to diagnose torsional deformities, make an indication for surgical treatment, or plan the amount of correction. However, no clear evaluation of different femoral torsion measurement methods for hips with excessive torsion has been performed to date.

Questions/purposes: (1) How does CT-based measurement of femoral torsion differ among five commonly used measurement methods? (2) Do differences in femoral torsion among measurement methods increase in hips with excessive femoral torsion? (3) What is the reliability and reproducibility of each of the five torsion measurement methods?

Methods: Between March and August 2016, we saw 86 new patients (95 hips) with hip pain and physical findings suggestive for femoroacetabular impingement at our outpatient tertiary clinic. Read More

Medicine (Baltimore) 2018 Dec;97(51):e13199

Department of Pediatric Orthopedics, Hunan Provincial People's Hospital, the First Affiliated Hospital of Hunan Normal University, Changsha, Hunan, China.

Rationale: Pain in the hip joint is a common symptom in children. The common diseases leading to pain in the hip joint in children include transient synovitis of the hip, septic arthritis of the hip, and Legg-Calve-Perthes disease.

Patient Concerns: A 7-year-old boy was admitted due to pain in the right hip joint and limping for more than 1 month. Read More

J Magn Reson Imaging 2018 Dec 17. Epub 2018 Dec 17.

Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota, USA.

Background: Legg-Calvé-Perthes disease (LCPD) is a childhood hip disorder thought to be caused by disruption of blood supply to the developing femoral head. There is potential for imaging to help assess revascularization of the femoral head.

Purpose: To investigate whether quantitative susceptibility mapping (QSM) can detect neovascularization in the epiphyseal cartilage following ischemic injury to the developing femoral head. Read More

Orthop J Sports Med 2018 Nov 12;6(11):2325967118807176. Epub 2018 Nov 12.

Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California, USA.

Background: The preoperative diagnosis of hip microinstability is challenging. Although physical examination maneuvers and magnetic resonance imaging findings associated with microinstability have been described, there are limited reports of radiographic features. In patients with microinstability, we observed a high incidence of a steep drop-off on the lateral edge of the femoral head, which we have named the "cliff sign. Read More

Clin Orthop Relat Res 2018 Dec;476(12):2351-2352

A. Noelle Larson, Associate Professor, Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA.

Am J Sports Med 2018 Dec 12;46(14):3446-3453. Epub 2018 Nov 12.

American Hip Institute, Westmont, Illinois, USA.

Background:: Hip arthroscopy for the treatment of instability in the setting of borderline dysplasia is controversial. Capsular management in such cases is an important consideration, and plication has been described as a reliable technique, with good midterm outcomes reported when indications are appropriate.

Hypothesis:: Patients with borderline dysplasia who have a lower lateral center-edge angle (LCEA) and greater age will be at a higher risk of failure after arthroscopic capsular plication. Read More

Osteoarthritis Cartilage 2019 Feb 4;27(2):326-335. Epub 2018 Nov 4.

Center for Excellence in Hip Disorders, Texas Scottish Rite Hospital for Children, Dallas, TX 75219, USA; Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, TX 75390-8883, USA. Electronic address:

Objective: Juvenile ischemic osteonecrosis (JIO) of the femoral head is one of the most serious hip disorders causing a permanent deformity of the femoral head in childhood. We recently reported that interleukin 6 (IL6) is predominantly increased in the hip synovial fluid of patients with JIO and that articular chondrocytes are primary source of IL6. This study investigated whether an inhibition of IL6 receptor improves cartilage preservation and bone healing in JIO. Read More

J Pediatr Orthop B 2019 Mar;28(2):100-106

Department of Diagnostic Radiology, Uppsala University Hospital, Uppsala, Sweden.

It is unclear how patient-reported outcome in patients with Legg-Calvé-Perthes disease (LCPD) is correlated with radiographic outcome. It was therefore the aim of our long-term follow-up to evaluate the agreement of patient-reported outcome measures (PROM) with radiographic outcome in patients with a history of unilateral LCPD and a femoral head involvement of more than 50%. We further investigated to what extent the functional outcome (range of motion and Trendelenburg sign) correlates with PROM and radiographic outcome. Read More

J Child Orthop 2018 Oct;12(5):472-479

Department of Orthopaedics, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.

Purpose: The containment orientated treatment of Legg-Calvé-Perthes disease (LCPD) affected hip joints is broadly accepted in the literature. The prerequisite is early recognition of loss of containment. An often-used quantitative MRI containment parameter is the cartilaginous acetabulum-head-index (CAHI). Read More

J Am Anim Hosp Assoc 2018 Nov/Dec;54(6):e54603. Epub 2018 Oct 1.

From the Department of Small Animal Medicine and Surgery, University of Georgia, Athens, Georgia (I.R.); and Athens Area Humane Society, Athens, Georgia (J.M.).

A 1 yr old castrated male shih tzu was evaluated for an acute right rear limb lameness and hyphema in the anterior chamber of the right eye. On initial examination, the dog was non-weight bearing on his right rear limb. Ophthalmic examination revealed a centrally located, superficial corneal ulcer in the right eye and blood in the anterior chamber. Read More

J Orthop 2018 Dec 7;15(4):984-987. Epub 2018 Sep 7.

Department of Medical Genetics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

Objective: The aim of this study was to assess the association of MTHFR and TNF-α genes polymorphisms with Legg-Calvé-Perthes' disease (LCPD) risk in the Iranian children.

Methods: A total of 45 children with LCPD and 55 healthy controls were recruited to the study. Genotyping was performed via the RFLP-PCR method and genetic risk was calculated by odds ratio (OR) with its corresponding 95% confidence interval (CI). Read More

Clin Orthop Relat Res 2018 Dec;476(12):2344-2350

J. I Kessler, Kaiser Permanente Southern California, Los Angeles, CA, USA P. C. Cannamela, University of Utah School of Medicine, Salt Lake City, Utah, USA.

Background: Although many authors have reported the incidence of Legg-Calvé-Perthes disease (LCPD), there have been few incidence studies in the United States on large, self-contained populations such as those within an integrated health system. Understanding the epidemiology and demographics of LCPD in this setting may help clinicians identify patients at the greatest risk and aid in diagnosis and subsequent treatment.

Questions/purposes: In this study we sought (1) to determine the incidence and demographics of LCPD in a large cohort of children and adolescents in a Southern California integrated healthcare system, and (2) to identify any demographic or clinical factors (such as age, sex, race/ethnicity, or BMI) that are independently associated with LCPD. Read More

J Pediatr Orthop 2018 Nov/Dec;38(10):e577-e583

Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University.

Background: The standard evaluation of epiphyseal involvement in Perthes disease is lateral pillar classification. However, it needs to be compared with contralateral normal hip leading to limited use in bilateral disease. We, therefore, develop a ratio between epiphyseal height and metaphyseal width of affected hips to estimate lateral pillar involvement. Read More

Pediatr Rev 2018 Sep;39(9):454-463

Montefiore Medical Center and the Children's Hospital at Montefiore, Bronx, NY.

Bone 2018 Nov 17;116:221-231. Epub 2018 Aug 17.

Center for Excellence in Hip Disorders, Texas Scottish Rite Hospital for Children, Dallas, TX 75219, USA; Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, TX 75390-8883, USA. Electronic address:

Legg-Calvé-Perthes disease (LCPD) is a childhood form of ischemic osteonecrosis of the femoral head which can produce a permanent femoral head deformity and early osteoarthritis. The femoral head deformity results from increased bone resorption and decreased bone formation during repair and remodeling of the necrotic femoral head. A recent study showed that a pro-inflammatory cytokine, interleukin-6 (IL-6), is significantly elevated in the synovial fluid of patients with LCPD. Read More

Case Rep Orthop 2018 9;2018:4362367. Epub 2018 Jul 9.

Intellijoint Surgical, Waterloo, ON, Canada.

Legg-Calve-Perthes disease is a rare condition characterized by avascular necrosis and malformation of the femoral head. For many patients, total hip arthroplasty (THA) is the only viable treatment option; however, there are challenges associated with THA in this population, primarily the equalization of leg lengths. Here, we present two cases of Legg-Calve-Perthes disease treated via total hip arthroplasty with the assistance of an imageless, computer-assisted navigation device. Read More

Iowa Orthop J 2018 ;38:197-202

Department of Orthopaedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, IA, U.S.A.

Background: Patients with Legg-Calvé-Perthes Syndrome (LCPS) are at an increased risk for developing osteoarthritis of the hip and undergoing total hip arthroplasty (THA) at an early age. Importantly, this younger age may put them at a higher risk for failure and revision surgery. The purpose of the study was to assess the clinical and radiographic outcomes as well as implant failure rate and risk for revision surgery at an average 20 years follow up. Read More

Indian J Orthop 2018 Jul-Aug;52(4):380-386

Department of Orthopaedic Surgery, Taipei Medical University Hospital, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.

Background: Legg-Calve-Perthes disease (LCPD) causes osteonecrosis of the femoral head (ONFH) by temporarily interrupting the blood supply in children. Even with potential toward bone regeneration and revascularization in LCPD, the prognosis depends on the deformity of femoral heads, and successful rate with the current treatments varies. Antiresorptive therapy such as bisphosphonate, which maintains mechanical stability of the femoral head by inhibiting necrotic bone resorption, has proven effective in animal models. Read More

Orthopade 2018 Sep;47(9):722-728

Klinik für Orthopädie, Uniklinikum RWTH Aachen, Aachen, Deutschland.

Legg-Calvé-Perthes disease is a multifactorial idiopathic necrosis of the hip that typically occurs in childhood between the ages of 3 and 12. Treatment adapted to the stadium of the disease and to the clinical findings is medical art. The treatment is focused on the preservation or recovery of the arthrogenic containment of the femoral head. Read More

Radiology 2018 Nov 31;289(2):386-395. Epub 2018 Jul 31.

From the Center for Magnetic Resonance Research (C.P.J., L.W., J.M.E.) and Departments of Radiology (C.P.J., L.W., J.M.E.), Veterinary Population Medicine (F.T.), and Veterinary Clinical Sciences (C.S.C.), University of Minnesota, 2021 6th St SE, Minneapolis, MN 55455; Center for Excellence in Hip Disorders, Texas Scottish Rite Hospital, Dallas, Tex (O.A., H.K.W.K.); and Department of Orthopedic Surgery, UT Southwestern Medical Center, Dallas, Tex (H.K.W.K.).

Purpose To determine whether quantitative MRI relaxation time mapping techniques can help to detect ischemic injury to the developing femoral head. Materials and Methods For this prospective animal study conducted from November 2015 to February 2018, 10 male 6-week-old piglets underwent an operation to induce complete right femoral head ischemia. Animals were humanely killed at 48 hours (n = 2) or 4 weeks (n = 8) after the operation, and the operated and contralateral-control femoral heads were harvested and frozen. Read More

Trials 2018 Jul 13;19(1):374. Epub 2018 Jul 13.

Institute of Translational Medicine, Institute in the Park, University of Liverpool, Prescott Road, Liverpool, L14 2AB, UK.

Background: Perthes' disease is an idiopathic osteonecrosis of a developmental hip that is most frequent in Northern Europe. Currently, the absence of a common set of standardised outcomes makes comparisons between studies of different interventions challenging. This study aims to summarise the outcomes used in clinical research of interventions for Perthes' disease and define a set of core outcomes (COS) to ensure that the variables of primary importance are measured and reported in future research studies investigating Perthes' disease. Read More

J Pediatr Orthop 2018 Jul 2. Epub 2018 Jul 2.

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

J Am Acad Orthop Surg 2018 Aug;26(15):526-536

From Gillette Children's Specialty Healthcare, St. Paul, MN (Dr. Laine and Dr. Novotny), the Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN (Dr. Laine), the Division of Orthopaedic Surgery and Sports Medicine, Children's National Health System, Washington, DC (Dr. Martin), Campbell Clinic Orthopaedics, Memphis, TN (Dr. Kelly), the Department of Orthopaedic Surgery and Biomedical Engineering, University of Tennessee, Memphis, TN (Dr. Kelly), and Le Bonheur Children's Hospital, Germantown, TN (Dr. Kelly).

Since the first description of Legg-Calvé-Perthes disease a century ago, the diagnosis, staging, prognosis, and treatment decisions have been based on plain radiographs. The goal of treatment is prevention of femoral head deformity, yet radiographic prognostic classifications are applied in the fragmentation stage, often after deformity occurs. These classifications are assigned too late in the progression of the disease to maximize the effects of intervention. Read More

J Am Acad Orthop Surg 2018 Aug;26(15):515-525

From Intermountain Healthcare, Salt Lake City, UT (Dr. Wylie), University of Utah, Salt Lake City (Dr. Peters), and University of Utah Hospital, Salt Lake City (Dr. Aoki).

Hip osteoarthritis (OA) exerts a significant burden on society, affecting 3% of Americans aged >30 years. Recent advances in the understanding of the pathoanatomy and pathomechanics of the hip have led to treatment options for young adults with hip pain. Femoroacetabular impingement, specifically cam-type femoroacetabular impingement, hip dysplasia, and the sequelae of pediatric hip disease can predispose the hip to early OA. Read More

Int Orthop 2018 Jun 18. Epub 2018 Jun 18.

Cleveland Clinic, Department of Orthopaedic Surgery, Cleveland, OH, USA.

Purpose: Osteonecrosis of the femoral head (ONFH) typically impacts middle-aged patients who are typically more active and in whom many surgeons would try to delay performing a total hip arthroplasty (THA). This poses a clinical decision-making challenge. Therefore, several options for joint preservation have been advocated, but varying indications and success rates have led to debate on when to use the various procedures. Read More

J Pediatr Orthop 2018 May 29. Epub 2018 May 29.

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

J Surg Orthop Adv Spring 2018;27(1):58-63

Department of Orthopaedics, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania.

Alternative medicine in pediatrics is expanding, with chiropractic now a common choice for families seeking alternative medical care. Currently, there is sparse information in the literature exploring the role of chiropractic in orthopaedic pathology. The objective of this case series is to present pediatric patients who received treatment from chiropractors and orthopaedic physicians as well as to review the respective existing research. Read More

Eur J Orthop Surg Traumatol 2018 Oct 25;28(7):1283-1290. Epub 2018 Apr 25.

Department of Pediatric Radiology, Geneva University Hospitals (HUGe), Rue Willy Donzé 6, 1211, Geneva, Switzerland.

Background: In children older than 5 years with a mild form of Legg-Calvé-Perthes disease, the outcome is difficult to predict. In this study, we retrospectively correlated gadolinium-enhanced subtracted (DGS) and diffusion (DWI) MRI findings to the radiographic assessment according to the Catterall and Herring et al. classifications and to the final score according to Stulberg et al. Read More

Int Orthop 2018 Dec 23;42(12):2961-2968. Epub 2018 Apr 23.

Department of Pediatric Orthopaedics, GuangZhou Women and Children's Medical Center, GuangZhou Medical University, 9th JinSui Road, GuangZhou, 510623, China.

Introduction: Bernese-type triple pelvic osteotomy (BTPO) combines periacetabular and triple innominate osteotomy techniques. However, studies that evaluate the clinical and radiographic outcomes of BTPO are scarce. The aim of this study is to report on the clinical and radiographic outcomes of ambulatory children with developmental dysplasia of the hip (DDH) or Legg-Calvé-Perthes disease (LCPD) managed with BTPO that were older than five years of age at the time of surgery. Read More

Acta Orthop Traumatol Turc 2018 May 26;52(3):216-221. Epub 2018 Mar 26.

Center for Joint Disease, Chonnam National University Hwasun Hospital, Jeonnam, Republic of Korea. Electronic address:

Objective: Disparity in size between femoral head and acetabulum could promote premature degeneration of the hip joint. The purpose of this study was to report the results of Kawamura's dome osteotomy for acetabular dysplasia due to sequelae of Perthes' disease.

Patients And Methods: Fourteen patients (14 hips) operated between 1999 and 2012 were retrospectively reviewed. Read More

J Pediatr Orthop 2018 Jul;38(6):e300-e304

Division of Orthopaedic Surgery, Children's Hospital of Philadelphia, Philadelphia, PA.

Background: Developmental dysplasia of the hip (DDH), which encompasses a wide spectrum of disease from mild dysplasia to frank dislocation, is one of the most common developmental deformities of the lower extremities and one of the leading causes of future osteoarthritis and hip arthroplasty. Legg-Calvé-Perthes disease (LCPD) results from a vascular insult to the growing femoral epiphysis, which in turn can create permanent morphologic changes to the hip joint. Slipped capital femoral epiphysis (SCFE) occurs when the proximal femoral physis fails allowing the epiphysis to displace in relation to the metaphysis. Read More

Clin Orthop Relat Res 2018 May;476(5):1055-1064

Section of Orthopaedics, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.

Background: Osteochondrosis includes numerous diseases that occur during rapid growth, characterized by disturbances of endochondral ossification. One example, Legg-Calvé-Perthes disease, is characterized by disruption of the blood supply to the femoral head epiphysis, and a systemic etiology often has been suggested. If this were the case, secondary osteochondroses at locations other than the hip might be expected to be more common among patients with Legg-Calvé-Perthes disease, but to our knowledge, this has not been evaluated in a nationwide sample. Read More

J Child Orthop 2018 Feb;12(1):47-54

Pediatric Orthopedic Department, Robert Debré University Hospital, Paris Diderot University, France.

Purpose: Sickle cell disease (SCD) is the most common cause of femoral head osteonecrosis (ONFH) during childhood with an overall prevalence of 10%. In children, spontaneous revascularization can occur, as in Legg-Calve-Perthes disease. Consequently, the aim of treatment is to restore proper hip containment to prevent joint arthritis. Read More

BMJ Open 2018 02 10;8(2):e019176. Epub 2018 Feb 10.

Division of Sports Traumatology, Department of Orthopedics, Aarhus University Hospital THG, Aarhus, Denmark.

Introduction: Hip arthroscopy has become a standard procedure in the treatment of hip joint pain not related to osteoarthritis or dysplasia in the young and active patient. There has been increasing focus on the contribution of the hip capsule to function and on stability following hip arthroscopy. It has been suggested that capsular closure after hip arthroscopy may prevent microinstability and macroinstability of the hip joint and reduce revision rate. Read More

Bone Joint Res 2018 Feb;7(2):148-156

School of Engineering and Computer Science, University of Hull, Cottingham Road, Kingstonupon-Hull HU6 7RX, UK.

Objectives: Legg-Calvé-Perthes' disease (LCP) is an idiopathic osteonecrosis of the femoral head that is most common in children between four and eight years old. The factors that lead to the onset of LCP are still unclear; however, it is believed that interruption of the blood supply to the developing epiphysis is an important factor in the development of the condition.

Methods: Finite element analysis modelling of the blood supply to the juvenile epiphysis was investigated to understand under which circumstances the blood vessels supplying the femoral epiphysis could become obstructed. Read More

Comput Methods Biomech Biomed Engin 2018 Feb 8;21(2):194-200. Epub 2018 Feb 8.

a School of Engineering and Computer Science , University of Hull , Hull , United Kingdom of Great Britain and Northern Ireland.

Legg-Calvé-Perthes disease (LCP) is one of the most poorly understood diseases in paediatric orthopaedics. One common trait of LCP is the marked morphological difference between healthy and pathological hips, early deviations of which (i.e. Read More

Pediatr Nurs 2017 Mar-Apr;43(2):96-7

Oncol Lett 2018 Jan 8;15(1):1319-1324. Epub 2017 Nov 8.

Department of Pediatric Orthopaedics, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei 050051, P.R. China.

Legg-Calvé-Perthes disease (LCPD) commonly onsets in adolescents, and threatens their health. However, the potential mechanism underlying LCPD remains unclear. MicroRNA (miR)-206 and SRY-box 9 (SOX9) serve an important role in chondrocytes; however, their role in LCPD remains ambiguous. Read More

J Pediatr Orthop 2019 Feb;39(2):e95-e101

Children's Hospital of Philadelphia, University of Pennsylvania Medical School, Philadelphia, PA.

Background: Although hinge abduction is recognized as an important finding in children with Legg-Calvé-Perthes disease, variable diagnostic criteria exist. The purpose of this study was (1) to test the interobserver and intraobserver agreement of the current definition of hinge abduction and (2) to develop consensus regarding key diagnostic features that could be used to improve our diagnostic criteria.

Methods: Four orthopaedic surgeons with subspecialty pediatric hip interest independently assessed 30 randomly ordered cases of Legg-Calvé-Perthes disease. Read More

Clin Orthop Surg 2017 Dec 10;9(4):397-404. Epub 2017 Nov 10.

Department of Orthopaedic Surgery, Center for Joint Disease, Chonnam National University Hwasun Hospital, Hwasun, Korea.

Background: In a previous study, we reported clinical and radiographic results of our modified Salter innominate osteotomy technique in 16 hips affected by Legg-Calvé-Perthes disease (LCPD) with an average follow-up of 31.8 months. In this study, we present the long-term results of the osteotomy in LCPD patients followed until physeal closure. Read More

Hip Int 2018 May 12;28(3):302-308. Epub 2017 Jan 12.

1 Department of Orthopaedic Surgery, Chungnam National University School of Medicine, Daejeon - South Korea.

Introduction: The residual hip deformities after Legg-Calvé-Perthes disease (LCPD) cause mechanical symptoms and are associated with a pathomechanical environment that can feature femoroacetabular impingement (FAI). The aim of this study is to evaluate the clinical and radiological outcomes in residual or healed LCPD after arthroscopic treatment.

Patients And Methods: We retrospectively reviewed patients with LCPD amongst patients with FAI who underwent arthroscopic treatment between January 2009 and June 2013. Read More

Acta Orthop Belg 2016 Dec;82(4):821-828

Background: Impingement ensures a narrow arc of pathologic loading in adolescent hips with sequelae of Perthes Disease. Proper surgical interference when the hip is still in the pre-arthritic stage restores function and protects the young hip from early degenerative changes.

Methods: Osteochondroplasty at the femoral head-neck junction and relative lengthening of the femoral neck by distal transfer of the greater trochanter was performed for 12 adolescents with combined intra-articular/extra-articular impingement due to sequelae of Perthes disease in terms of coxa magna, coxa plana, coxa brevis, with an overriding greater trochanter. Read More

Pediatr Radiol 2018 03 27;48(3):350-358. Epub 2017 Nov 27.

Department of Radiology, Vanderbilt University Medical Center, Vanderbilt Children's Hospital, Nashville, TN, USA.

Background: Evaluating postoperative patients with hardware is challenging following surgical intervention for hip maladies such as femoral neck fractures and slipped capital femoral epiphysis (SCFE). These children are at increased risk of developing avascular necrosis, and imaging may be requested to confirm or exclude this diagnosis. Children with Legg-Calvé-Perthes disease can be monitored for restoration of blood flow to the capital femoral epiphysis to guide management and help with prognosis. Read More

J Orthop Sci 2018 Jan 20;23(1):161-167. Epub 2017 Nov 20.

Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Nagoya City University, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan.

Background: The Herring lateral pillar classification is widely used for the classification of Legg-Calvé-Perthes disease, but is not applied at the early stage of Legg-Calvé-Perthes disease because it is typically applied at the late fragmentation stage. The purpose of this study was to investigate the correlation between the early appearance on magnetic resonance imaging of the acetabular labrum and lateral pillar involvement in Legg-Calvé-Perthes disease.

Methods: Non-contrast magnetic resonance images of 26 hips in 25 children with early-stage Legg-Calvé-Perthes disease were retrospectively reviewed. Read More

Orthop Traumatol Surg Res 2018 Feb 16;104(1S):S107-S112. Epub 2017 Nov 16.

Clinique chirurgicale infantile, hôpital Charles-Nicolle, centre hospitalier universitaire (CHU) de Rouen, 1, rue de Germont, Rouen 76031, France.

Current knowledge of the causes and risk factors of Legg-Calvé-Perthesdisease (LCPD) does not allow effective preventive strategies. The outcome in adulthood is usually good. Hip osteoarthritis rarely develops before 50 years of age. Read More

J Paediatr Child Health 2017 Nov;53(11):1077-1085

Department of Orthopaedics, Children's Hospital at Westmead, Sydney, New South Wales, Australia.

Growing children are susceptible to a number of disorders to their lower extremities of varying degrees of severity. The diagnosis and management of these conditions can be challenging. With musculoskeletal symptoms being one of the leading reasons for visits to general practitioners, a working knowledge of the basics of these disorders can help in the appropriate diagnosis, treatment, counselling, and specialist referral. Read More

J Orthop Res 2018 May 28;36(5):1526-1535. Epub 2017 Nov 28.

Department of Bioengineering, Center for Musculoskeletal Research, University of California-San Diego, 9500 Gilman Dr., La Jolla, California, 92093.

Legg-Calvé-Perthes disease (LCPD) and slipped capital femoral epiphysis (SCFE) are two common pediatric hip disorders that affect the 3-dimensional shape and function of the proximal femur. This study applied the principles of continuum mechanics to statistical shape modeling (SSM) and determined 3-D metrics for the evaluation of shape deformations in normal growth, LCPD, and SCFE. CT scans were obtained from 32 patients with asymptomatic, LCPD, and SCFE hips ((0. Read More

Ned Tijdschr Geneeskd 2017 ;161:D1575

Catharina Ziekenhuis, afd. Radiologie, Eindhoven.

A 10-year-old boy presented at the radiology department with pain in the right knee. Radiographs of the knee revealed dens metaphyseal bands and subchondral epiphyseal sclerosis as a result of periodic bisphosphonate administration for the treatment of Legg-Calvé-Perthes disease three years ago. Read More