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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

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

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

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

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 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

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

Musculoskelet Surg 2018 Aug 12;102(2):153-157. Epub 2017 Oct 12.

Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India.

Background: Most of the information available about Legg-Calve-Perthes disease (LCPD) at present is gained through imaging modalities including plain radiographs and magnetic resonance imaging (MRI). But the accuracy of MRI in this disease and its predictive value to reveal various intra-articular pathologies is not known. We correlated the findings of MRI with those seen on hip arthroscopy in children with active stage of LCPD. Read More

J Orthop Sci 2018 Jan 2;23(1):156-160. Epub 2017 Oct 2.

Department of Orthopaedic and Spine Surgery, Fukuoka Children's Hospital, Fukuoka, Japan.

Background: Treatment with a brace is the first choice as conservative treatment via the containment method for Legg-Calvé-Perthes disease (LCPD). The purpose of this study is to evaluate clinical outcomes and influential factors of conservative treatment with the non-weight-bearing abduction brace for LCPD.

Methods: One hundred thirty hips in 130 patients were examined in this study. Read More

BMC Musculoskelet Disord 2017 Sep 5;18(1):386. Epub 2017 Sep 5.

Department of Orthopedics, West China Hospital/West China School of Medicine, Sichuan University, 37# Wuhou Guoxue Road, Chengdu, 610041, People's Republic of China.

Background: The purpose of this study was to evaluate 10-year outcomes in cementless monobloc total hip arthroplasty (THA) in a group of hips with Legg-Calve-Perthes disease (LCPD).

Methods: We reviewed 71 patients (88 hips) who underwent cementless THA with a diagnosis of LCPD from 2003 to 2009. From the total of 71 patients, 34 men and 37 women with an average age of 49. Read More

Biomed Mater Eng 2017 ;28(4):443-456

Department of Orthopaedic Surgery, Hvidovre University Hospital, Kettegaards Allé 30, 2650 Hvidovre, Denmark.

Perthes' disease is a destructive hip joint disorder characterized by malformation of the femoral head in young children. While the morphological changes have been widely studied, the biomechanical effects of these changes still need to be further elucidated. The objective of this study was to develop a method to investigate the biomechanical alterations in Perthes' disease by finite element (FE) contact modeling using MRI. Read More

Medicine (Baltimore) 2017 Aug;96(31):e7723

aDepartment of Preventive Medicine, Chonbuk National University Medical School bDepartment of Orthopaedic Surgery, Chonbuk National University Medical School, Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital and Research Institute for Endocrine Sciences, Jeonju, Republic of Korea.

This is a retrospective observational study. Greater trochanteric epiphysiodesis (GTE) has been recommended to prevent Trendelenburg gait and limitation of the hip joint motion due to trochanteric overgrowth after femoral varus osteotomy (FVO) in Legg-Calvé-Perthes disease (LCPD). However, capital femoral physeal arrest frequently occurs in patients with severe disease (lateral pillar C), so GTE might not be as effective in these patients. Read More

J Magn Reson Imaging 2018 Apr 28;47(4):875-890. Epub 2017 Jul 28.

The Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, Maryland, USA.

Although postcontrast imaging has been used for many years in musculoskeletal imaging, dynamic contrast enhanced (DCE) MRI is not routinely used in many centers around the world. Unlike conventional contrast-enhanced sequences, DCE-MRI allows the evaluation of the temporal pattern of enhancement in the musculoskeletal system, perhaps best known for its use in oncologic applications (such as differentiating benign from malignant tumors, evaluating for treatment response after neoadjuvant chemotherapy, and differentiating postsurgical changes from residual tumor). However, DCE-MRI can also be used to evaluate inflammatory processes such as Charcot foot and synovitis, and evaluate bone perfusion in entities like Legg Calve Perthes disease and arthritis. Read More

Bone Joint J 2017 Jul;99-B(7):987-992

Assaf Harofeh Medical Center, Tzrifin 70300, Israel and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Aims: To assess the long-term effect of distal trochanteric transfer (DTT) on the clinical and radiographic outcomes of patients with Legg-Calvé-Perthes' disease (LCPD) following a varus derotational osteotomy (VDRO).

Patients And Methods: For this single centre cross-sectional retrospective study we analysed the data of 22 patients (24 hips) with LCPD who had greater trochanteric overgrowth (GTO), following a VDRO performed in our institution between 1959 and 1983. GTO was defined as an articular trochanteric distance (ATD) of < 5 mm. Read More

Acta Orthop 2017 Oct 14;88(5):522-529. Epub 2017 Jun 14.

a Department of Paediatric Orthopaedic Surgery , Oslo University Hospital.

Background and purpose - Different radiographic classifications have been proposed for prediction of outcome in Perthes disease. We assessed whether the modified lateral pillar classification would provide more reliable interobserver agreement and prognostic value compared with the original lateral pillar classification and the Catterall classification. Patients and methods - 42 patients (38 boys) with Perthes disease were included in the interobserver study. Read More

Bone Joint J 2017 Apr;99-B(4):440-444

Seoul National University, Bundang Hospital, 166 Gumi-ro, Bundang-gu, Seongnam 463-707, South Korea.

Aims: Modular or custom-made femoral components have been preferred for total hip arthroplasty (THA) in patients with a history of Perthes' disease because of the distortion in the anatomy of the proximal femur. However, it has not been established whether a monobloc cementless stem will fit the distorted proximal femur or whether the results of the procedure are satisfactory in this group of patients.

Patients And Methods: We reviewed 68 consecutive patients who had undergone THA for childhood Perthes' disease between June 2003 and December 2008. Read More

Acta Orthop 2017 06 14;88(3):354-357. Epub 2017 Mar 14.

a Orthopaedicum-Hamburg.

Am J Med Genet A 2017 Jun 3;173(6):1663-1667. Epub 2017 Mar 3.

Department of Pediatrics, Division of Genetic and Genomic Medicine, University of California, Irvine, Orange, California.

Tricho-Rhino-Phalangeal syndrome is a rare autosomal dominant genetic disorder caused by mutations in the TRPS1 gene. This malformation syndrome is characterized by distinctive craniofacial features including sparse scalp hair, bulbous tip of the nose, long flat philtrum, thin upper vermilion border, and protruding ears. Skeletal abnormalities include cone-shaped epiphyses at the phalanges, hip malformations, and short stature. Read More

J Korean Med Sci 2017 Apr;32(4):581-586

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

We analyzed the causes leading to total hip arthroplasty (THA), aimed to clarify the incidence of femoroacetabular impingement (FAI) among the causes, and compared the incidence in Korea with those in other countries. From January 2000 to December 2014, 1,206 hips of 818 patients who underwent primary THA at our institute were reviewed retrospectively in terms of radiographs and electronic charts. The radiographs and radiographic parameters were reviewed and measured by 2 of the authors, who are orthopedic surgeons. Read More

Quant Imaging Med Surg 2016 Oct;6(5):515-524

Department of Medical and Surgical Sciences and Advanced Technologies "G. F. Ingrassia", Section of Radiology, University of Catania, Catania, Italy.

Background: Mixed vascular nevus (or nevus vascularis mixtus) represents an admixture of cutaneous vascular malformations of the telangiectatic type and angiospastic spots of nevus anemicus. It can occur as an purely cutaneous trait or as a hallmark of a neurocutaneous phenotype (mixed vascular nevus syndrome) characterised by the combination of: (I) paired vascular (telangiectatic and anemic) twin nevi and brain abnormalities of the Dyke-Davidoff-Masson type (i.e. Read More

Homo 2017 Jan 28;68(1):10-17. Epub 2016 Nov 28.

Department of Biomedical and Surgical Specialties Sciences, University of Ferrara, Ferrara, Italy. Electronic address:

Legg-Calvé-Perthes is a very rare disease involving childhood osteochondrosis of the femoral head due to interruption of its blood supply. The etiology is unknown. The signs of the pathology are well described in the literature but few paleopathological cases have been reported, mostly dating from Late Antiquity to Early Middle Ages. Read More

Clin Orthop Surg 2016 Dec 4;8(4):452-457. Epub 2016 Nov 4.

Department of Orthopaedic Surgery, Dong-A University College of Medicine, Busan, Korea.

Background: To evaluate the efficacy of arthrodiastasis for Legg-Calve-Perthes disease.

Methods: Arthrodiastasis was conducted using external fixator devices (Orthofix) in 7 patients at least 8 years of age with a diagnosis of Legg-Calve-Perthes disease. The average follow-up was 80 months (range, 32 to 149 months), and their average age was 9. Read More

Hip Int 2017 Feb 14;27(1):92-95. Epub 2016 Nov 14.

Department of Orthopedic Surgery, Shaanxi Provincial People's Hospital, Xi'an - China.

Background: Legg-Calvé-Perthes disease (LCPD) is a paediatric form of osteonecrosis that ultimately heals but will cause femoral head and acetabular deformities. The purpose of this study was to investigate the early serum measurement of osteocalcin in children with femoral head necrosis compared with that of healthy children.

Methods: 20 patients with LCPD (4 girls and 16 boys) and 20 healthy volunteers (5 girls and 15 boys) were enrolled. Read More

J Orthop Res 2017 09 14;35(9):2051-2058. Epub 2016 Dec 14.

Center for Excellence in Hip Disorders, Texas Scottish Rite Hospital for Children, 2222 Welborn Street, Dallas 75219, Texas.

The purpose of this study was to quantify femoral head deformity in patients with Legg-Calvé-Perthes disease (LCPD) using a novel three dimensional (3D) magnetic resonance imaging (MRI) reconstruction and volume based analysis. Bilateral femoral heads of 17 patients (mean age 9.9 ± 2. Read More

J Bone Joint Surg Am 2016 11;98(22):e103

Division of Pediatric Orthopaedic Surgery Department of Orthopaedic Surgery New York University/The Hospital for Joint Diseases New York, NY.

J Bone Joint Surg Am 2016 Nov;98(22):1897-1904

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

Background: Legg-Calvé-Perthes disease is a juvenile form of osteonecrosis of the femoral head. The purpose of this study was to use serial perfusion magnetic resonance imaging (MRI) to determine the pattern and rate of revascularization of the femoral heads of patients with the active stage of Legg-Calvé-Perthes disease.

Methods: We performed a prospective study of 29 patients (30 hips) with a mean age (and standard deviation) of 8. Read More

J Pediatr Orthop B 2017 Jul;26(4):329-335

Institute for Rare Diseases and Department of Orthopaedic Surgery, Korea University Medical Center, Guro Hospital, Seoul, Republic of Korea.

Although external fixation methods have been described for proximal femoral osteotomy for various etiologies, none are dedicated to a single disease entity. Our study introduces a technique of proximal femoral osteotomy and fixation with a monolateral external fixator system in Legg-Calvé-Perthes disease (LCPD). Twenty-three patients (19 males, four females) with LCPD underwent surgery at our institute between 2004 and 2012. Read More

Klin Padiatr 2017 Mar 12;229(2):76-81. Epub 2016 Oct 12.

Dept. of Pediatric Surgery, Children's Hospital, Inselspital, University Hospital Bern, Bern, Switzerland.

Transient synovitis is the most common hip joint disorder in children. Perthes disease occurs around the same age and may not be distinguishable to an episode of transient synovitis in the early stage. Therefore all children in our clinic with transient synovitis underwent a follow-up X-ray 3 months later to detect Perthes disease at an early stage. Read More

Clin Orthop Relat Res 2017 Apr;475(4):1120-1127

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

Background: The goal of periacetabular osteotomy (PAO) is to improve the insufficient coverage of the femoral head and achieve joint stability without creating secondary femoroacetabular impingement. However, the complex tridimensional morphology of the dysplastic acetabulum presents a challenge to restoration of normal radiographic parameters. Accurate acetabular correction is important to achieve long-term function and pain improvement. Read More

Clin Orthop Relat Res 2017 Apr;475(4):1192-1207

Department of Orthopaedic Surgery, Inselspital, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland.

Background: Magnetic resonance arthrogram (MRA) with radial cuts is presently the best available preoperative imaging study to evaluate chondrolabral lesions in the setting of femoroacetabular impingement (FAI). Existing followup studies for surgical treatment of FAI have evaluated predictors of treatment failure based on preoperative clinical examination, intraoperative findings, and conventional radiography. However, to our knowledge, no study has examined whether any preoperative findings on MRA images might be associated with failure of surgical treatment of FAI in the long term. Read More

J Orthop Res 2017 07 22;35(7):1453-1460. Epub 2016 Sep 22.

Center for Excellence in Hip Disorders, Texas Scottish Rite Hospital for Children, 2222 Welborn Street, Dallas, 75219, Texas.

Bone morphogenetic protein (BMP)-2 and ibandronate (IB) decrease the femoral head deformity following ischemic osteonecrosis of the femoral head (ONFH). The purpose of this study was to determine the effects of BMP-2 and IB on the mineral content and nanoindentation properties of the bone following ONFH. ONFH was surgically induced in the femoral head of piglets. Read More

J Orthop Sci 2016 Nov 10;21(6):836-840. Epub 2016 Aug 10.

Department of Orthopedic Surgery, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; Department of Orthopedic Surgery, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; Medical Research Center, Seoul National University, 103 Daehak-ro, Jongno-gu Seoul 03080, Republic of Korea.

Background: Total hip arthroplasty (THA) for sequelae of Legg-Calve-Perthes disease (LCPD) involves specific concerns for deformity, leg length discrepancy (LLD), and relatively young age. Excellent long-term outcome has been proven after Alumina-Alumina (Al-Al) THA for relatively young patients, however, there was no study for Al-Al THA for LCPD sequelae. The aim of this study is to evaluate the results of Al-Al THA for LCPD sequelae and to compare the results with those for adult-onset ONFH, in which THA is necessitated in relatively young age and excellent long term outcome has been proven after Al-Al THA. Read More

Clin Radiol 2016 Nov 9;71(11):1071-82. Epub 2016 Aug 9.

Diagnostic Imaging, Monash Health, 246 Clayton Road, Clayton, VIC 3168, Australia.

Diffusion-weighted imaging (DWI) is a magnetic resonance imaging (MRI) sequence that has a well-established role in neuroimaging, and is increasingly being utilised in other clinical contexts, including the assessment of various skeletal disorders. It utilises the variability of Brownian motion of water molecules; the differing patterns of water molecular diffusion in various biological tissues help determine the contrast obtained in DWI. Although early research on the clinical role of DWI focused mainly on the field of neuroimaging, there are now more studies demonstrating the promising role DWI has in the diagnosis and monitoring of various osseous diseases. Read More

J Bone Joint Surg Am 2016 Aug;98(15):1277-85

Department of Orthopedic Surgery, Assaf Harofeh Medical Center, Zerifin, Israel.

Background: Varus derotational osteotomy (VDRO) is one of the most common surgical treatments for Legg-Calvé-Perthes disease, yet its long-term results have not been fully assessed. We aimed to determine the long-term clinical and radiographic outcomes following VDRO.

Methods: Forty patients (43 hips) who underwent VDRO for Legg-Calvé-Perthes disease at our institution from 1959 to 1983, and participated in a follow-up study completed 10 years earlier, were approached for the present study. Read More

Case Rep Orthop 2016 11;2016:7426410. Epub 2016 Jul 11.

Department of Orthopedic Surgery, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku Ward, Tokyo 162-8666, Japan.

Transient synovitis (TS) of the hip develops spontaneously in childhood; it usually has a good prognosis and is a self-limiting disease. However, its pathology is not well known. We describe a case of Legg-Calvé-Perthes disease (LCPD) that seemingly developed due to TS. Read More

Orthopade 2016 Aug;45(8):673-7

Orthopädische Klinik, Klinikum Dortmund, Beurhausstr. 40, 44137, Dortmund, Deutschland.

Background: The Tönnis and Kalchschmidt triple pelvic osteotomy (TPO) has been performed at the Klinikum Dortmund for more than 30 years. In more than 5000 cases the TPO has proven its potential to deal with even severe dysplastic hips. TPO can be easily combined with other hip procedures as intertrochanteric osteotomies and even impingement treatment can easily be done. Read More

Acta Radiol 2016 Jul;57(7):e79-94

Pan Afr Med J 2016 22;23:51. Epub 2016 Feb 22.

Department of Orthopedic Surgery, Sinai Hospital of Baltimore,Baltimore, USA.

Pediatr Ann 2016 Apr;45(4):e144-9

Legg-Calve-Perthes disease (LCPD) is the insidious onset of idiopathic avascular necrosis of the hip in the pediatric population. The disease encompasses a wide spectrum of pathology, from mild with no long-term sequelae to severe with permanent degenerative change of the hip joint. A pediatric patient with hip pathology may initially only present with knee or thigh pain, thus obligating the clinician to maintain awareness about the hip during examination. Read More

Bone Joint J 2016 Apr;98-B(4):569-75

Sørlandet Sykehus, Arendal, Postboks 783 Stoa, NO-4809 Arendal, Norway.

Aims: The aims of this study were to describe the course of non-operatively managed, bilateral Perthes' disease, and to determine specific prognostic factors for the radiographic and clinical outcome.

Patients And Methods: We identified 40 children with a mean age of 5.9 years (1. Read More

Hip Int 2016 May 8;26(3):301-6. Epub 2016 Feb 8.

Erzincan University Faculty of Medicine, Erzincan - Turkey.

Objective: The main purposes of the present study were to analyse the long-term clinical and radiographic results of femoral varus derotation osteotomy performed in a group of patients with the diagnosis of Legg-Calvé-Perthes (LCP) disease and to compare the effects of age, lateral pillar classification, radiographic stage according to Waldenström's classification, and the amount of varisation obtained on long-term results.

Design: The study group consisted of 21 hips. The mean postoperative follow-up time was 25. Read More

J Am Coll Radiol 2016 Feb;13(2):147-55

Brigham & Women's Hospital, Boston, Massachusetts.

Osteonecrosis of the hip (Legg-Calvé-Perthes) is a common disease, with 10,000-20,000 symptomatic cases annually in the United States. The disorder affects both adults and children and is most frequently associated with trauma and corticosteroid usage. The initial imaging evaluation of suspected hip osteonecrosis is done using radiography. Read More

J Pediatr Orthop 2017 Dec;37(8):563-569

*Division of Orthopedic Surgery, Rady Children's Hospital, San Diego, CA †Naval Medical Center Portsmouth, Portsmouth, VA.

Background: Legg-Calve-Perthes disease (LCPD), in its severe form, remains a challenge. More recent classifications, particularly the modified Elizabethtown classification, have highlighted the chronologic stage of LCPD and its effect on surgical outcome. Hip severity and age of disease onset have also been shown to be powerful determinants of outcome. Read More

Clin Orthop Surg 2015 Dec 13;7(4):497-504. Epub 2015 Nov 13.

Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Background: Standard treatments may provide adequate containment in mild to moderate Legg-Calve-Perthes disease (LCPD), but they can be problematic in more severe cases. The purpose of this study was to report the results of combined shelf acetabuloplasty with femoral varus osteotomy in severe LCPD.

Methods: We reviewed 12 patients who had undergone combined shelf acetabuloplasty with femoral varus osteotomy. Read More

Radiology 2016 May 25;279(2):562-70. Epub 2015 Nov 25.

From the Division of Pediatric Orthopaedics, Seoul National University Children's Hospital, Seoul, Korea (W.J.Y., I.H.C., T.J.C., W.J.); Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea (C.Y.C., M.S.P.); Department of Orthopaedic Surgery, Gacheon University Gil Hospital, Incheon, Korea (E.S.C.); and Department of Radiology, Seoul National University Hospital, 101 Daehak-ro Jongno-gu, Seoul 110-744, Korea (J.E.C.).

Purpose: To determine whether changes in diffusion and/or contrast enhancement are of prognostic value in the early stage of Legg-Calvé-Perthes disease (LCPD).

Materials And Methods: This study was approved by the institutional review board, and written informed consent was obtained from patient parents. Diffusion and contrast agent-enhanced magnetic resonance (MR) imaging studies were performed in 46 children (37 boys and nine girls; mean age, 7. Read More