Correlation of functional outcome and X-ray findings after Perthes disease

Westhoff, Bettina; Zilkens, Christoph; Reith, Andrea; Jelinek, Eva; Martiny, F.; Willers, Reinhart; Krauspe, Rüdiger

doi:10.1007/s00264-011-1254-2

Cited by 8 publications

(4 citation statements)

References 17 publications

(15 reference statements)

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“…[160][161][162] A femoral head with a SDS value of 10 or below is regarded as a spherical head. 160,161 Apart from the radiological outcome measure of femoral head sphericity, it is important that functional outcomes evaluating hip and lower limb function are also measured 163 as also patient-reported outcomes. 164,165 However, there are strong correlations between the radiological outcome, functional outcome, and patient-reported outcomes of treatment of LCPD.…”

Section: Outcome Evaluationmentioning

confidence: 99%

Epidemiology, natural evolution, pathogenesis, clinical spectrum, and management of Legg–Calvé–Perthes

Joseph,

Shah,

Perry

2023

Journal of Children's Orthopaedics

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Background: Legg–Calvé–Perthes disease is a self-limiting disorder that develops in children following interruption of the blood supply to the capital femoral epiphysis. This review outlines the current knowledge on the epidemiology, natural evolution, clinical spectrum, and management of the disease. Methods: The literature pertaining to these aspects of the disease were studied and summarized in this review. Results: Epidemiological studies suggest that environmental factors contribute to the causation of the disease. Incidence rates monitored over time indicate that the incidence of Legg–Calvé–Perthes disease is declining. The natural evolution followed on sequential plain radiographs enables division of the disease into Stages Ia, Ib, IIa, IIb, IIIa, IIIb, and IV. Reversible deformation of the capital occurs in Stages Ia–IIa simply on standing while irreversible deformation may occur in Stages IIb and IIIa. Treatment of Legg–Calvé–Perthes disease in Stages Ia–IIa aims to prevent the femoral head from getting deformed by containment and avoidance of weight-bearing. In Stages IIb and IIIa, treatment aims to remedy the effects of early irreversible deformation of the femoral head. In Stage IIIb and IV, treatment is directed to correcting the altered shape of the femoral head. The impression that these treatment methods are helpful is based on poor quality evidence. Conclusion: There is an urgent need to undertake Level I studies to establish the efficacy of currently treatment. Level of evidence: level V.

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Section: Outcome Evaluationmentioning

confidence: 99%

Epidemiology, natural evolution, pathogenesis, clinical spectrum, and management of Legg–Calvé–Perthes

Joseph,

Shah,

Perry

2023

Journal of Children's Orthopaedics

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“…The Harris Hip Score was used for clinical evaluations, such as activities of daily living, pain level, and hip function, by two independent pediatric orthopedic surgeons (7)(8)(9)(10) . Radiological evaluations were obtained preoperatively from the lateral pillar and the Catterall classification and from the Stulberg classification during the follow-up period (4,11,12) .…”

Section: Outcome Measuresmentioning

confidence: 99%

Age and Factors Associated with Clinical and Radiological Outcomes of Surgical Containment in Legg-Calve-Perthes Disease

2022

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Purpose: To determine the factors associated with clinical and radiological outcomes in patients with Legg-Calve-Perthes disease (LCPD) treated with containment methods. Methods: This retrospective cohort study was conducted from 2007 – 2017. Patients diagnosed with LCPD in the fragmentation stage and treated using surgical containment methods were included. Study factors were age at diagnosis, preoperative radiographs analyzed for lateral pillar staging and Catterall classification. Outcome measurements were final follow-up radiograph, classified using modified Stulberg grading, and final clinical outcome, classified by Harris Hip Score. Results: We analyzed 44 hips. The average age of subjects during diagnosis and follow-up was 8.1 and 12.7 years, respectively. The average length of follow-up was 58.6 months. Nineteen hips were evaluated as “good” (Stulberg I or II), 22 hips as “fair” (Stulberg III), and four hips as “poor” (Stulberg IV); no hips were classified as Stulberg V. Although not significant, the combination of Salter osteotomy and femoral varus osteotomy yielded better outcomes than varus osteotomy alone in the group >8 years old (p=0.247). The median age of 7 (7 – 8) years old was correlated with “good to excellent” Harris Hip Score while median age of 9 years was significantly correlated with the score of “fair” and “poor” (p=0.018). Lateral pillar A and B yielded significantly better results than lateral pillar C (p=0.014). Conclusion: The containment methods demonstrated favorable outcomes when treating patients < 9 years. Lateral pillars A and B had good end results. Combined pelvic and femoral osteotomy can improve radiographic and clinical outcomes.

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“…4 SOUBORNÝ REFERÁT CURRENT CONCEPTS REVIEW U pacientů se špatným klinickým výsledkem byl zjištěn menší abduktorový moment při měření izokinetickou dynamometrií a větší abduktorový moment při chůzi. V další studii bylo zjištěno, že po proběhlé chorobě pouze 30 % probandů vykázalo normální parametry chůze (42,43). V této studii byli probandi rozděleni dle funkce kyčelního kloubu ve frontální rovině na 3 skupiny: Starší děti preferovaly na postižené straně zátěž v addukčním postavení během fáze jednotné opory, měly více postižené kyčle dle rtg a vzorem chůze je přetěžovaly.…”

Section: Obr 12 Graf Momentu Síly V Kyčelním Kloubu Ve Frontální Rovi...unclassified

Gait Analysis in Patients with Hip Disorders

Urbášek¹,

Poul²

2016

Acta Chir. orthop. Traum. Cech.

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SOUBORNÝ REFERÁT CURRENT CONCEPTS REVIEWPasažérská část vyvíjí svalovou činnost zejména k udržení posturální integrity. Hmotnost této části těla představuje obvykle 70 % hmotnosti celkové. Těžiště těla se ÚVODRecentní studie ukazují, že hodnocení výsledků jak konzervativní, tak i chirurgické terapie na pohybovém aparátu se neobejde bez hodnocení chůze. Běžné ortopedické ambulance jsou vybaveny pro klinické vyšetření vleže, v sedu a ve stoje, méně již však pro hodnocení chůze probanda. I pro pořízení jednoduchého videozáznamu je třeba toto vyšetření uskutečnit mimo ambulanci, např. na dostatečně dlouhé chodbě. Ortopedické učebnice až na výjimky (6, 7) podrobně rozebírají komplexní klinické vyšetření pacienta, chůze je obvykle zmíněna jen okrajově. Podstatně větší pozornost je věnována chůzi v rehabilitačním lékařství (41). Pohybová analýza v podmínkách laboratoře chůze vybavené optoelektronickým kinematickým kamerovým systémem a silovými plotnami (motion analysis) se začala v klinické praxi nejdříve rozvíjet u pacientů s dětskou mozkovou obrnou (

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Correlation of functional outcome and X-ray findings after Perthes disease

Cited by 8 publications

References 17 publications

Epidemiology, natural evolution, pathogenesis, clinical spectrum, and management of Legg–Calvé–Perthes

Epidemiology, natural evolution, pathogenesis, clinical spectrum, and management of Legg–Calvé–Perthes

Age and Factors Associated with Clinical and Radiological Outcomes of Surgical Containment in Legg-Calve-Perthes Disease

Gait Analysis in Patients with Hip Disorders

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