Changes in the lateral pillar classification in Perthes' disease

Kuroda, Takayuki; Mitani, Shigeru; Sugimoto, Yukihiko; Asaumi, Koji; Endo, Hidenori; Akazawa, Hirofumi; Nakagomi, Tadashi; Ozaki, Toshifumi

doi:10.1097/bpb.0b013e32832b07b1

Cited by 7 publications

(5 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…36 The prognosis was found to be uniformly poor in group C, irrespective of age and treatment and was uniformly good in groups A, B, B/C before the age of 8 years irrespective of treatment. 66,67 It was also difficult to classify in bilateral cases. For the very young patients with ages <6 years, an overall of 80% had good results.…”

Section: Salter Thompson Classification (1984)mentioning

confidence: 99%

Prognosis and Prognostic Factors of Legg-Calve-Perthes Disease

Cheng

Lam

2011

Journal of Pediatric Orthopaedics

View full text Add to dashboard Cite

This is an overall review of the published literature in the past 100 years on the prognosis and prognostic factors of Legg-Calve-Perthes disease (LCPD). There were considerable limitations and inadequacies of the reported series. LCPD is not a common disease, and thus most reports were based on relatively small series collected retrospectively over a long period of time without clearly defined case selection, assessment, treatment, follow-up period, and outcome measures. Few studies, if any, would satisfy the strict definition of prognosis, which should only mean those prognostic factors derived from observation of the natural history of the disease-that is the uninterrupted progressive development of a disease that runs its course from onset-inception to resolution without any intervention or treatment. This review attempted to summarize from the mixed series of studies the generally described demographic, clinical, and radiologic prognostic factors of LCPD. The most important radiologic prognostic signs include the extent of femoral capital epiphysis involvement, the degree of metaphyseal changes, and lateral subluxation of femoral head and depend significantly on the time of assessment after the onset of the disease. More detailed discussions on prognostication based on the structured classification systems that have evolved in the past few decades would be described.

show abstract

Section: Salter Thompson Classification (1984)mentioning

confidence: 99%

Prognosis and Prognostic Factors of Legg-Calve-Perthes Disease

Cheng

Lam

2011

Journal of Pediatric Orthopaedics

View full text Add to dashboard Cite

show abstract

“… 2002 , Kuroda et al. 2009 ). Another limitation is the difficult use of the classification in bilateral cases since there is a lack of reference height to compare with.…”

mentioning

confidence: 98%

Radiographic classifications in Perthes disease

et al. 2017

View full text Add to dashboard Cite

Background and purposeDifferent 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 methods42 patients (38 boys) with Perthes disease were included in the interobserver study. Their mean age at diagnosis was 6.5 (3–11) years. 5 observers classified the radiographs in 2 separate sessions according to the Catterall classification, the original and the modified lateral pillar classifications. Interobserver agreement was analysed using weighted kappa statistics. We assessed the associations between the classifications and femoral head sphericity at 5-year follow-up in 37 non-operatively treated patients in a crosstable analysis (Gamma statistics for ordinal variables, γ).ResultsThe original lateral pillar and Catterall classifications showed moderate interobserver agreement (kappa 0.49 and 0.43, respectively) while the modified lateral pillar classification had fair agreement (kappa 0.40). The original lateral pillar classification was strongly associated with the 5-year radiographic outcome, with a mean γ correlation coefficient of 0.75 (95% CI: 0.61–0.95) among the 5 observers. The modified lateral pillar and Catterall classifications showed moderate associations (mean γ correlation coefficient 0.55 [95% CI: 0.38–0.66] and 0.64 [95% CI: 0.57–0.72], respectively).InterpretationThe Catterall classification and the original lateral pillar classification had sufficient interobserver agreement and association to late radiographic outcome to be suitable for clinical use. Adding the borderline B/C group did not increase the interobserver agreement or prognostic value of the original lateral pillar classification.

show abstract

“…Activity modification and avoidance of weight bearing may be of some value given that osteonecrosis weakens the femoral head [81]. A downside to this form of treatment is increased osteoclastic activity and disuse osteopenia.…”

Section: Treatment Of Juvenile Fhomentioning

confidence: 99%

Childhood Femoral Head Osteonecrosis

Kim

Larson

Fletcher

et al. 2011

Clinic Rev Bone Miner Metab

View full text Add to dashboard Cite

Femoral head osteonecrosis (FHO) is potentially a devastating condition of the hip joint that can affect children and adults. The most serious outcome of this condition is the development of painful progressive osteoarthritis necessitating a total hip replacement at a relatively young age. This review focuses on childhood FHO with a special attention to the conditions that are more commonly seen in the pediatric population: Legg-CalvePerthes disease, corticosteroid-associated FHO, and sickle cell disease.

show abstract

Changes in the lateral pillar classification in Perthes' disease

Cited by 7 publications

References 16 publications

Prognosis and Prognostic Factors of Legg-Calve-Perthes Disease

Prognosis and Prognostic Factors of Legg-Calve-Perthes Disease

Radiographic classifications in Perthes disease

Childhood Femoral Head Osteonecrosis

Contact Info

Product

Resources

About