Radiographic results of combined Salter innominate and femoral osteotomy in Legg–Calvé–Perthes disease in older children

Javid, Mahzad; Wedge, John H.

doi:10.1007/s11832-009-0171-z

Cited by 28 publications

(20 citation statements)

References 42 publications

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“…Although the disease extent and lateral subluxation of the femoral head in this series were more severe than those of other studies, the results did not differ from other studies that used other advanced surgical techniques ( Table 2 ). 19 20 21 22 23 24) …”

Section: Discussionmentioning

confidence: 99%

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Outcomes of Combined Shelf Acetabuloplasty with Femoral Varus Osteotomy in Severe Legg-Calve-Perthes (LCP) Disease: Advanced Containment Method for Severe LCP Disease

Lim

Shim

2015

Clin Orthop Surg

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BackgroundStandard 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.MethodsWe reviewed 12 patients who had undergone combined shelf acetabuloplasty with femoral varus osteotomy. The indications for this type of operation were: (1) above 8 years of age at clinical onset; (2) massive femoral epiphysis involvement (Catterall group 4, lateral pillar C); (3) femoral head lateral subluxation on the anteroposterior radiograph; and (4) impending hinged abduction on preoperative magnetic resonance imaging or arthrography. The mean age was 9.3 years (range, 8 to 10.8 years). The patients were clinically evaluated with Iowa hip score and leg length discrepancy at the final follow-up. Radiographic outcome was assessed using the Stulberg classification to evaluate femoral head sphericity. The presence of osteoarthritis was evaluated by the Tonnis classification. Correlation analysis was conducted to analyze the preoperative factors that were strongly associated with patients' outcomes.ResultsThe mean follow-up period was 10.1 years (range, 7.1 to 13.2 years). Functional grade was excellent in all patients at last follow-up (mean, 92; range, 82 to 99). The mean leg length discrepancy after skeletal maturity was 0.9 cm (range, 0 to 1.7 cm). There were no significant complications or need for additional surgery. Radiographically, 92% of patients reached satisfactory outcomes: Stulberg grade I, 0 cases; Stulberg grade II, 4 cases (34%); Stulberg III, 7 cases (58%), Stulberg IV, 1 case (8%); and Stulberg V, 0 cases. There was no osteoarthritis by Tonnis classification.ConclusionsThe surgical outcomes for combined shelf acetabuloplasty with femoral varus osteotomy in severe LCPD patients over 8 years old are comparable with other advanced surgical methods. In the cases of severe disease that match our inclusion criteria, our containment method could be another treatment option.

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Section: Discussionmentioning

confidence: 99%

“…The choice of surgery depends on the surgeon's preference or experience. Advanced containment methods have been used for severe disease including: Salter innominate osteotomy combined with a proximal femoral varus osteotomy, 19 22 26) triple pelvic osteotomy, 23 27 28) and shelf acetabuloplasty.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Combined Shelf Acetabuloplasty with Femoral Varus Osteotomy in Severe Legg-Calve-Perthes (LCP) Disease: Advanced Containment Method for Severe LCP Disease

Lim

Shim

2015

Clin Orthop Surg

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“…While, incidence rates vary considerably between countries, there is also significant variation within countries and even within regions. [9][10][11] Lameness and pain at the diseased site are the major characteristics of this disease. For some patients, there is no discomfort or pain at the hip during the early stages of the disease.…”

Section: Discussionmentioning

confidence: 99%

Clinical observation of early rehabilitation of childhood femoral head necrosis in a low stress environment

Nie

Dai

et al. 2015

Int Surg J

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“…9,10 Several surgical procedures have addressed patients with the advanced stage of the disease; these include femoral and pelvic osteotomies. 11 Both procedures change the anatomy of the hip joint, which may hinder future joint arthroplasty. The challenge of treating LCPD is to prevent degenerative arthritis by preserving the spherical shape of the femoral head.…”

Section: Introductionmentioning

confidence: 99%

<p>Role of Arthrodiastasis Using Hinged Monolateral External Fixator Without Soft Tissue Release in Advanced Stage of Legg–Calve–Perthes Disease</p>

Samarah

Nimer

Karmi

et al. 2020

TCRM

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Radiographic results of combined Salter innominate and femoral osteotomy in Legg–Calvé–Perthes disease in older children

Abstract: Simultaneous femoral and Salter innominate osteotomies in older children with a higher LP grouping can marginally improve the radiographic outcome in comparison with the natural history in LPB/C and LPC cases by converting a number of poor results to fair results.

Cited by 28 publications

References 42 publications

Outcomes of Combined Shelf Acetabuloplasty with Femoral Varus Osteotomy in Severe Legg-Calve-Perthes (LCP) Disease: Advanced Containment Method for Severe LCP Disease

Outcomes of Combined Shelf Acetabuloplasty with Femoral Varus Osteotomy in Severe Legg-Calve-Perthes (LCP) Disease: Advanced Containment Method for Severe LCP Disease

Clinical observation of early rehabilitation of childhood femoral head necrosis in a low stress environment

<p>Role of Arthrodiastasis Using Hinged Monolateral External Fixator Without Soft Tissue Release in Advanced Stage of Legg–Calve–Perthes Disease</p>

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