Residual Shortening After Legg-Calve-Perthes Disease, Focusing on the Response of the Ipsilateral Tibia

Rowe, Sung-Man; Moon, Eun Sun; Song, Eun-Kyoo; Yoon, Tae Mi; Kim, Myung-Sun; Cho, Seong-Beom

doi:10.1097/01.bpo.0000151060.85227.67

Cited by 7 publications

(7 citation statements)

References 12 publications

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“…Grzegorzewski et al [14] stated that varus osteotomy produces more shortening than do other methods of treatment. In contrast, Rowe et al [31] reported less residual shortening in patients treated by varus osteotomy of the proximal femur than in those treated by abduction bracing. However, our findings contrast with those of both of these studies, because we observed similar frequencies of LLD regardless of the patients' age at diagnosis, sex, or the treatment method.…”

Section: Discussionmentioning

confidence: 84%

“…Several analyses of the relationship between LCPD and LLD have documented shortening of the affected limb ranging in length from 1 mm to 7 cm [9,14,28,31,35,39]. However, the incidence and predictors of LLD in patients with LCPD remain unclear; furthermore, it is not known whether parameters such as age at diagnosis, sex, type of treatment, and the extent of femoral head involvement can predict the occurrence of LLD.…”

Section: Introductionmentioning

confidence: 99%

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Can Residual Leg Shortening Be Predicted in Patients With Legg-Calvé-Perthes’ Disease?

Park

Jang

Song

2013

Clinical Orthopaedics &Amp; Related Research

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Background Although Legg-Calvé-Perthes' disease (LCPD) is frequently associated with varying degrees of femoral head deformity and leg length discrepancy (LLD), no factors that predict residual shortening have been clearly identified. Questions/purposes We attempted to determine whether (1) the extent of femoral head involvement; (2) varus osteotomy; and (3) patient demographic characteristics are associated with LLD at skeletal maturity in patients with LCPD. Methods We retrospectively reviewed the records of 168 skeletally mature patients with unilateral LCPD. The mean age at diagnosis was 7 years (range, 2-14 years). The extent of femoral head involvement was determined from the initial radiographs using the Herring lateral pillar and Catterall classifications. LLD was defined as shortening by C 1.0 cm as measured from scanograms. The patient's sex and the treatment modalities used were also recorded.

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Section: Discussionmentioning

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Can Residual Leg Shortening Be Predicted in Patients With Legg-Calvé-Perthes’ Disease?

Park

Jang

Song

2013

Clinical Orthopaedics &Amp; Related Research

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“…The characteristics of the included studies [ 1 , 9 , 10 , 32 , 44 - 61 ] are reported in Multimedia Appendix 1 .…”

Section: Resultsmentioning

confidence: 99%

Surgical Treatments for Legg-Calvé-Perthes Disease: Comprehensive Review

Maleki¹,

Qoreishy²,

Bahrami³

2021

Interact J Med Res

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Background Legg-Calvé-Perthes disease (LCPD) is a common public health problem that usually occurs between the ages of 4 and 8 years, but it can occur between the ages of 2 and 15 years. This condition occurs due to the interruption of blood supply to the femoral head. Up to now, different surgical and nonsurgical treatments, including femoral varus osteotomy, innominate osteotomy, pelvic osteotomies, triple osteotomy, Chiari osteotomy, and shelf acetabuloplasty, have been suggested for noncontainable LCPD hips. Objective The aim of this comprehensive review was to investigate the various surgical techniques used for LCPD. Methods An advanced electronic search of the English-language literature was performed from October 8 to 14, 2020. The electronic databases PubMed, MEDLINE, Web of Science, Embase, Ovid, and Google scholar were searched using appropriate search terms. A manual search of references also was performed. After retrieving the studies, duplicates were removed, and the remining studies were screened based on the title, abstract, and full text. The quality of the selected articles was assessed, and the required data were extracted from eligible articles. Results A total of 22 studies were included in the review. Based on the results of the reviewed studies, there are three main factors that influence the treatment outcomes in patients with Perthes disease. These factors are onset age, femoral head involvement severity, and treatment method. The disease has a poor prognosis in children over 8 years old, but this group of patients can also benefit from advanced surgical methods. In patients aged less than 6 years, the disease has a generally good prognosis, but in those aged between 6 and 8 years, its prognosis is variable. Thus, the need for surgical intervention requires close observation of signs. Once any head signs are observed, dynamic arthrography is beneficial before choosing the treatment approach. Conclusions This review provides clinicians with a brief guideline for the treatment of patients with LCPD.

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“…One concern, however, was that it further shortened the affected leg and thus increased the need for the epiphyseal arrest of the normal opposite leg 9, [20][21][22] . It is generally accepted that the amount of the shortening of the affected legs in LCPD depends almost exclusively on the severity of inhibition of endochondral ossification in the proximal femoral growth plate.…”

Section: DI Is Sc Cu Us Ss Si Io On Nmentioning

confidence: 99%

“…In my previous study 20) , our measurements showed that the mean total femoral and tibial shortening was 15.0 mm in the abduction orthosis (AO) group and 9.2 mm in the FVO group (P<0.001). A shortening of 10 mm or more was observed in 66% of the AO group and 40% of the FVO group.…”

Section: DI Is Sc Cu Us Ss Si Io On Nmentioning

confidence: 99%

The Long Term Results of Femoral Varus Osteotomy in Patients with Legg-Calve-Perthes Disease

Wie¹,

Rowe²,

Jung³

et al. 2009

J Korean Hip Soc

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Purpose: The purpose of this study was to evaluate the long term results of performing femoral varus osteotomy (FVO) for the treatment of Legg-Calve-Perthes disease (LCPD). Materials and Methods:We selected 35 LCPD patients who received FVO and they were followed up to the time their skeletons' matured. The inclusion criteria were patients in a fragmentation stage, the patients were in Catterall group Ⅲ or Ⅳ, and the patients underwent a teleoroentgenographic examination at the time of full skeletal maturity. Results:The radiological outcome at the time of skeletal maturity was assessed using Stulberg's classification. The final results were 4 hips in class I, 17 hips in class II, 13 hips in class III, one hip in class IV and none in class V. The satisfactory results (good+fair hips) were 34 hips (97%). Significant shortening (>10 mm) was observed in 12 hips (34%). In 35 patients, 5 (14%) had same leg length (less than 2 mm difference), 27 (77%) had shortening of 2 mm or more, and 3 had lengthening of 2 mm or more in the operated limb. Of these 12 patients with significant shortening, only 3 patients (9%) showed shortening of 21 mm or more. Conclusion:FVO is a reliable method for managing LCPD in patients who are in Catterall group III or IV and who are in the fragmentation stage of disease.

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Residual Shortening After Legg-Calve-Perthes Disease, Focusing on the Response of the Ipsilateral Tibia

Cited by 7 publications

References 12 publications

Can Residual Leg Shortening Be Predicted in Patients With Legg-Calvé-Perthes’ Disease?

Can Residual Leg Shortening Be Predicted in Patients With Legg-Calvé-Perthes’ Disease?

Surgical Treatments for Legg-Calvé-Perthes Disease: Comprehensive Review

The Long Term Results of Femoral Varus Osteotomy in Patients with Legg-Calve-Perthes Disease

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