Comparison of the results from simple radiography, from before to after Salter osteotomy, in patients with Legg-Calvé-Perthes disease

Abstract

ObjectivesTo determine whether the clinical variables and preoperative classification of patients with Legg-Calvé-Perthes disease (LCPD) who undergo Salter osteotomy correlate with the radiographic result at the time of skeletal maturity.MethodsIn this retrospective cohort study, 47 individuals with LCPD who were treated using Salter osteotomy (1984–2004) were evaluated. The patients were evaluated according to sex, skin color, side affected and age at which osteotomy was performed. The preoperative radiographs were analyzed in accordance with the classifications of Waldenström, Catterall, Laredo and Herring. The radiographs obtained at the time of skeletal maturity were classified using the Stulberg method.ResultsThe mean age at the time of surgical treatment was 82.87 months (6.9 years). The age presented a statistically significant correlation with the Stulberg grades at skeletal maturity (p < 0.001). Patients over the age of 6.12 years tended to present less favorable results. The variables of sex, skin color and side affected did not present any statistically significant correlation with the prognosis (p = 0.425; p = 0.467; p = 0.551, respectively). Only the Laredo classification presented a statistically significant correlation with the final result given by the Stulberg classification (p = 0.001). The other classifications used (Waldenström, Catterall and Herring) did not present any correlation between the time at which surgery was indicated and the postoperative result.ConclusionsThe age at which the patients underwent surgical treatment and the Laredo classification groups were the only variables that presented significant correlations with the Stulberg classification.

Legg-Calv�-Perthes disease: classifications and prognostic factors

“…The classification of Laredo (30) ( Table 5) has a high prognostic value (31). Nevertheless, its difficulties of realization make it little usable in clinical routine.…”

Legg-Calvé-Perthes hastalığında pelvik osteotomiler

“…İyi sonuçların genellikle 6-8 yaş arasında Lateral Pillar sınıflamasına göre Tip B ve B/C kalçalarla ilgili olduğu, Tip C tipi kalçalarda ise sonuç-ların daha kötü olduğu vurgulanmıştır. [14,46] Herring ve arkadaşları [47] , farklı tedavi yöntemlerini karşılaştırdıkları çok merkezli ileriye dönük çalışmada, başlangıç yaşları 6-8 yıl arasında olan olgularda en başarılı sonuçları Salter osteotomisiyle tedavi ettikleri grupta bulmuşlardır (%69 Stulberg Tip I ve II).…”

Management of Patients With Legg-Calvé-Perthes Disease at a Single Center in Jeddah, Saudi Arabia

“…It is the main form of hip disease in children, with an incidence rate of 2-294 per 1,000,000 children [2]. Despite the many studies that have been conducted, the etiology and optimal treatment remain unclear [4,5].…”

“…Researchers have indicated that the classification of LCPD corresponds to the disease stage, outcome, and predictors of outcome [3]. Understanding the disease's pathophysiology helps identify four progression stages through radiography, including initiation, fragmentation, re-ossification, and healing [4]. Outcomes have also been classified radiographically based on the femoral head shape and joint congruency [3].…”

“…In the context of treatment, there is strong evidence that early intervention has the most favorable outcomes [4]. Overall, the treatment aims to reduce hip pain and hip stiffness and maintain hip mobility.…”