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Artif Intell Med 2021 May 24;115:102057. Epub 2021 Mar 24.

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

As a result of most of the bone disorders seen in hip joints, shape deformities occur in the structural form of the hip joint components. Image-based quantitative analysis and assessment of these deformities in bone shapes are very important for the evaluation, treatment, and prognosis of the various hip joint bone disorders. In this article, a novel approach for the image-based computerized quantitative analysis of proximal femur shape deformities is presented. Read More

Pediatr Radiol 2021 Apr 1. Epub 2021 Apr 1.

Division of Pediatric Radiology, Department of Imaging Sciences, University of Rochester Medical Center, 601 Elmwood Ave., Rochester, NY, 14642, USA.

Diffusion-weighted MRI, or DWI, is a fast, quantitative technique that is easily integrated into a morphological MR acquisition. The ability of DWI to aid in detecting multifocal skeletal pathology and in characterizing tissue cellularity to a level beyond that possible with other techniques makes it a niche component of multiparametric MR imaging of the skeleton. Besides its role in disease detection and establishing cellularity and character of osseous lesions, DWI continues to be examined as a surrogate biomarker for therapeutic response of several childhood bone tumors. Read More

J Orthop Res 2021 Mar 31. Epub 2021 Mar 31.

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

This study investigated the sensitivity of T1ρ and T2 relaxation time mapping to detect acute ischemic injury to the secondary ossification center (SOC) and epiphyseal cartilage of the femoral head in a piglet model of Legg-Calvé-Perthes disease. Six piglets underwent surgery to induce global right femoral head ischemia and were euthanized 48 h later. Fresh operated and contralateral-control femoral heads were imaged ex vivo with T1, T2, and T1ρ mapping using a 9. Read More

Pediatr Radiol 2021 Mar 30. Epub 2021 Mar 30.

Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA.

The increasing use of contrast-enhanced ultrasound (CEUS) has opened exciting new frontiers for musculoskeletal applications in adults and children. The most common musculoskeletal-related CEUS applications in adults are for detecting inflammatory joint diseases, imaging skeletal muscles and tendon perfusion, imaging postoperative viability of osseous and osseocutaneous tissue flaps, and evaluating the malignant potential of soft-tissue masses. Pediatric musculoskeletal-related CEUS has been applied for imaging juvenile idiopathic arthritis and Legg-Calvé-Perthes disease and for evaluating femoral head perfusion following surgical hip reduction in children with developmental hip dysplasia. Read More

Klin Lab Diagn 2021 Mar;66(2):104-109

Federal Budgetary State Institution «National Medical Research Center» Traumatology and Orthopedics «named after academician G.A. Ilizarov of the Ministry of Health of Russia».

The increase in the number of patients with hip pathologies among children of different ages makes the diagnosis and treatment of these diseases one of the most actually existing problems in modern orthopedics. The aim of the work was to determine the features of the lipid peroxidation system - antioxidant protection and hemogram indices in children with various forms of hip joint pathology. The results of a preoperative examination of 47 patients aged 6-15 years (average age 10. Read More

J Arthroplasty 2021 Jul 13;36(7):2518-2522. Epub 2021 Feb 13.

Department of Orthopaedic Surgery, Washington University School of Medicine, Barnes-Jewish Hospital, St. Louis, MO.

Background: Complications and patient-reported outcomes (PROs) of total hip arthroplasty (THA) in patients with Legg-Calve-Perthes disease (LCPD) have demonstrated variable results. The purpose of this study was to use a validated grading scheme to analyze complications associated with THA in patients with residual LCPD deformities. Second, we report PROs and intermediate-term survivorship in this patient population. Read More

Clin Sports Med 2021 Apr 5;40(2):385-398. Epub 2021 Feb 5.

Department of Orthopaedics, San Antonio Military Medical Center, 3851 Roger Brooke Drive, Fort Sam Houston, TX 78234, USA. Electronic address:

This article provides concise and up-to-date information on the most common hip pathologies that affect adolescent athletes. We cover the evaluation and treatment of avulsion injuries, stress fractures, slipped capital femoral epiphysis (SCFE), femoroacetabular impingement, developmental dysplasia of the hip, Legg-Calve-Perthes disease, and coxa saltans focusing on minimizing advanced imaging and using conservative therapy when applicable. Although this is not an all-encompassing list of disorders, it is key to understand these hip pathologies because these injuries occur commonly and can also have detrimental complications if not diagnosed and addressed early, especially SCFE and femoral neck stress fractures. Read More

BMC Musculoskelet Disord 2021 Jan 6;22(1):32. Epub 2021 Jan 6.

Section of Orthopaedics, Department of Surgical Sciences, Section of Paediatric Orthopaedic Surgery, Uppsala University, Uppsala, Sweden.

Purpose: Legg-Calvé-Perthes disease (LCPD) and its association with cardiovascular diseases, obesity and hypertension has been consistently observed but remains cloudy. This study aimed to investigate the presence of hypertension and overweight/obesity at diagnosis of LCPD and at a 2-year follow-up and its association with age, sex and lateral pillar classification.

Method: We compared blood pressure (BP) (n = 93) and body mass index (BMI) (n = 125) in patients registered in the Perthes' register - a part of the Swedish pediatric orthopedic quality register (SPOQ) - with normative data for children with the same age and sex. Read More

Morphologie 2021 Jun 26;105(349):143-147. Epub 2020 Dec 26.

Chirurgie ONIRIS, École Vétérinaire de Nantes, 44307 Nantes cedex 3, France.

Legg Calvé Perthes disease (LCPD) is a developmental abnormality that usually affects young small breed dogs. Although the etiology is still uncertain, the pathogenesis is very similar to that described in humans. Diagnosis with physical examination and medical imaging is relatively easy. Read More

Int J Paleopathol 2021 Mar 21;32:61-73. Epub 2020 Dec 21.

German Archaeological Institute, Department of Natural Sciences, Im Dol 2-6, 14195, Berlin, Germany. Electronic address:

Objective: This study discusses the challenges and possibilities of establishing a definition for Ancient Rare Diseases (ARD) in a probable case of Legg-Calvé-Perthes Disease (LCPD) from the Bronze Age cemetery Kudachurt 14, situated in the Northern Caucasus.

Materials: We investigated the skeletal remains of a male aged 35-45 years at death. For comparison we examined other males buried at Kudachurt 14 (n = 24) and reviewed 22 LCPD cases from the paleopathological literature. Read More

J Pediatr Orthop B 2020 Dec 9. Epub 2020 Dec 9.

Faculty of Medicine, University of Montpellier 1, Center Hospitalier Universitaire Lapeyronie, Montpellier, France.

Objectives: To compare the effect of triple pelvic osteotomy (TPO) in Legg-Calvé-Perthes disease (LCPD) on acetabular version in a group of patients who developed a femoroacetabular impingement (FAI) and a control group without FAI.

Methods: Patients who received a TPO for unilateral LCPD were retrospectively included. Patients with bilateral LCPDs, requiring TPO with femoral procedures, or with incomplete imaging were excluded. Read More

J Biol Regul Homeost Agents 2020 Jul-Aug;34(4 Suppl. 3):285-287. Congress of the Italian Orthopaedic Research Society

IRCCS Istituto Ortopedico Galeazzi, Milano, Italy.

Bilateral secondary osteoarthritis of the hip may affect also young patients following bilateral hip diseases such as slipped capital femoral epiphysis and developmental hip dysplasia. We report the case of an 18- year old male with a previous diagnosis of Legg-Calvé-Perthes disease who underwent a bilateral total hip arthroplasty through minimally invasive direct anterior approach, with optimal results at 1-year follow up. Read More

J Pediatr Orthop 2021 Feb;41(2):93-98

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

Background: Deformity index (DI) and extrusion index (EI) are 2 radiographic methods currently used to quantify femoral head deformity in the active stages of Legg-Calvé-Perthes disease. This study aimed to quantify the interobserver reproducibility of the 2 methods using a large, international group of pediatric orthopaedic surgeons with diverse clinical experience.

Methods: Radiographs of patients (age 6 to 11 y at time of diagnosis) prospectively enrolled in an international multicenter-cohort study, were measured by members of our study group. Read More

BMC Musculoskelet Disord 2020 Nov 18;21(1):759. Epub 2020 Nov 18.

Faculty of Medicine, University of Berne, Berne, Switzerland.

Background: Legg-Calvé-Perthes (LCP) is a common orthopedic childhood disease that causes a deformity of the femoral head and to an adaptive deformity of the acetabulum. The altered joint biomechanics can result in early joint degeneration that requires total hip arthroplasty. In 2002, Ganz et al. Read More

JBI Evid Synth 2021 05;19(5):1211-1221

BC Children's Hospital Research Institute, Vancouver, BC, Canada.

Objective: This review aims to identify all examples of the application of statistical shape models to the human hip joint, with a focus on methodology, validation, and applications.

Introduction: Abnormal hip joint morphology (eg, deformity secondary to Legg-Calvé-Perthes disease) is an important precursor to osteoarthritis. Clinical radiographs are often used to characterize deformity and provide indication for surgical correction, but it is unclear whether radiographs can adequately describe three-dimensional deformity. Read More

Acta Orthop Traumatol Turc 2020 Sep;54(5):530-534

Department of Data Management and Biostatistics, Ege University, School of Medicine ARGEFAR, İzmir, Turkey.

Objective: The aim of this study was to determine the role of hip arthrography in the treatment decision making for children with Legg-Calvé-Perthes disease (LCPD).

Methods: A total of 47 consecutive children with LCPD (42 boys, 5 girls; mean age=7.5 years; range=6-10 years) who underwent operative treatment were included in the study. Read More

BMC Musculoskelet Disord 2020 Nov 5;21(1):718. Epub 2020 Nov 5.

Section of Orthopaedics, Department of Surgical Sciences, Section of Paediatric Orthopaedic Surgery, Uppsala University, Uppsala, Sweden.

Background: Range of abduction often decreases during Legg-Calvé-Perthes Disease (LCPD) disease. However, a good range of abduction is required during the course of LCPD, especially when containment surgery should be performed. This study aimed to investigate how many patients registered in the Swedish Pediatric Orthopedic Quality register (SPOQ) with LCPD had reduced range of abduction at diagnosis in relation to sex or age at diagnosis or severity of disease (lateral pillar class at the time at diagnosis), if physiotherapy (PT) was prescribed and has a beneficial impact in maintaining (or increasing) abduction and if the range of abduction at diagnosis before fragmentation stage is predictive for the lateral pillar classification at fragmentation stage. Read More

Clin Endocrinol (Oxf) 2021 Apr 20;94(4):590-597. Epub 2020 Nov 20.

Great Ormond Street Hospital for Children, London, UK.

Objective: Growth hormone deficiency (GHD) is usually treated with recombinant human GH (rhGH), and this has been rarely associated with hip disorders. We analysed the clinical data of patients with congenital GHD receiving rhGH who had associated hip dysplasia or Legg-Calve-Perthes disease (LCPD), with a view to determining whether the hip dysplasia was associated with the underlying disease or with rhGH treatment.

Design: We performed a retrospective analysis of paediatric and adolescent patients seen between 1992-2018 with congenital GHD and hip disorders. Read More

J Pediatr Orthop B 2020 11;29(6):618

Karadeniz Technical University, School of Medicine, Orthopaedics and Traumatology Department, Trabzon, Turkey.

J Orthop Surg Res 2020 Aug 14;15(1):329. Epub 2020 Aug 14.

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

Purpose: The orthopaedic use of resorbable poly lactic-co-glycolic acid (PLGA) implants carries multiple potential benefits. To our knowledge, only one publication exists regarding the use of PLGA implants in pelvic osteotomies in children, and data regarding resorption and potential side effects are lacking for resorbable pelvic screws in children. The aim of this study is to present an MRI-based evaluation of the resorption pattern and local tissue reactions in a paediatric case series after pelvic osteotomies fixated with PLGA screws. Read More

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

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

Hip Int 2020 Sep 25;30(5):587-591. 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

J Pediatr Orthop B 2020 11;29(6):618-619

Department of Orthopaedic Surgery, Aichi Children's Health and Medical Center, Obu, Aichi, Japan.

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

Comput Med Imaging Graph 2020 04 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

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

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

Hip Int 2021 May 26;31(3):417-423. 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

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

J. Haskel, O. Feder, P. Castañeda, NYU Langone Orthopedic Hospital, New York, NY, USA.

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