The Declining Incidence of Legg-Calve-Perthes’ Disease in Northern Ireland: An Epidemiological Study

Mullan, Conor J.; Thompson, Lara J.; Cosgrove, Aidan

doi:10.1097/bpo.0000000000000819

Cited by 13 publications

(4 citation statements)

References 20 publications

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“…During this time, the proportion of LCPD versus all pediatric surgical admissions also declined by 52%. This trend appears to be similar to the declining LCPD incidence reported in other countries 5,16…”

Section: Discussionsupporting

confidence: 87%

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Declining Rates of Legg–Calvé–Perthes Surgery in the United States: National Trends Using the Kids’ Inpatient Database and Pediatric Health Information System

LaGreca

Nickel²,

Finch³

et al. 2023

Journal of Pediatric Orthopaedics

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Background: In 2004 and 2008 two large prospective, multicenter studies were published which resulted in improved understanding of operative indications for the treatment of Legg–Calvé–Perthes disease (LCPD) based on patient age, disease severity, and resultant radiographic outcomes. The primary aim of this study is to evaluate the trends in surgical management of LCPD in the United States prior, and subsequent to, the publication of these landmark studies. Methods: Cross-sectional retrospective analysis of US pediatric hospitalizations for the surgical management of LCPD was conducted using the Kids’ Inpatient Database from 2000 to 2016. Patients 12 years of age and younger were included who had a primary admission diagnosis of LCPD and a LCPD-related procedure during the hospitalization. Data was subsequently weighted to produce national-level estimates and variables pertaining to patient age group, procedure, demographics, and hospital characteristics were analyzed. In a post hoc analysis, the results of the Kids’ Inpatient Database were also corroborated with the Pediatric Health Information System database. Results: A weighted sample of 2786 LCPD surgical admissions met inclusion and exclusion criteria; 11.2% of surgical admissions were patients below 6 years of age, 35.9% were 6 to 8 years of age, and 52.9% were above 8 years of age. There was a significant decrease in admissions for surgical management of LCPD in all age groups over time, however there was no appreciable change in the proportion of LCPD surgical admissions performed among the above 8 to below 12, above 6 to below 8, or below 6 years age groups. Femoral osteotomy remained the most common surgical procedure, while other osteotomy types, including pelvic and unspecified osteotomies involving the hip, decreased over time (P<0.001). Conclusions: There is a decreasing rate of hospital admissions for LCPD surgery since 2000, perhaps indicating a decline in incidence of disease. Furthermore, despite evidence supporting LCPD surgical outcomes related to patient age, there has been no change in the proportion of patients undergoing surgery by age group over time. Level of Evidence: Level III—retrospective study.

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Section: Discussionsupporting

confidence: 87%

“…This trend appears to be similar to the declining LCPD incidence reported in other countries. 5,16 The racial diversity of the LCPD cohort did not change across the study period, there was a maintained white predominance. During this same time, however, there was an increase in the diversity of the US child population.…”

Section: Discussionmentioning

confidence: 97%

Declining Rates of Legg–Calvé–Perthes Surgery in the United States: National Trends Using the Kids’ Inpatient Database and Pediatric Health Information System

LaGreca

Nickel²,

Finch³

et al. 2023

Journal of Pediatric Orthopaedics

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“…The heterogeneous prevalence reported opens the discussion for the examination of possible environmental and social factors involved in the aetiology of the disease[1-3,29]. In support of this, three studies[21,26,87] reported a possible association between the decrease in the incidence and lifestyle changes over recent years, exposure to environmental risk factors like smoking, delayed epiphyseal ossification, low birthweight, child deprivation and obesity. However, the results are not definitive.…”

Section: Discussionmentioning

confidence: 92%

Aetiology of Legg-Calvé-Perthes disease: A systematic review

Pavone

Chisari

Vescio

et al. 2019

WJO

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BACKGROUNDLegg-Calvé-Perthes disease (LCPD) is a clinical condition affecting the femoral head of children during their growth. Its prevalence is set to be between 0.4/100000 to 29.0/100000 children less than 15 years of age with a peak of incidence in children aged from 4 years to 8 years. LCPD aetiology has been widely studied, but it is still poorly understood.AIMTo analyse the available literature to document the up-to-date evidence on LCPD aetiology.METHODSA systematic review of the literature was performed regarding LCPD aetiology, using the following inclusion criteria: studies of any level of evidence, reporting clinical or preclinical results and dealing with the aetiology or pathogenesis of LCPD. Two reviewers searched the PubMed and Science Direct databases from their date of inception to the 20th of May 2018 in accordance with the Preferred Reporting Items for Systemic Reviews and Meta-Analyses guidelines. To achieve the maximum sensitivity of the search strategy, we combined the terms: ‘‘Perthes disease OR LCPD OR children avascular femoral head necrosis” with “pathology OR aetiology OR biomechanics OR genetics” as either key words or MeSH terms.RESULTSWe include 64 articles in this review. The available evidence on LCPD aetiology is still debated. Several hypotheses have been researched, but none of them was found decisive. While emerging evidence showed the role of environmental risk factors and evidence from twin studies did not support a major role for genetic factors, a congenital or acquired predisposition cannot be excluded in disease pathogenesis. One of the most supported theories involved mechanical induced ischemia that evolved into avascular necrosis of the femoral head in sensible patients.CONCLUSIONThe literature available on the aetiology of LCPD presents major limitations in terms of great heterogeneity and a lack of high-profile studies. Although a lot of studies focused on the genetic, biomechanical and radiological background of the disease, there is a lack of consensus on one or multiple major actors of the etiopathogenesis. More studies are needed to understand the complex and multifactorial genesis of the avascular necrosis characterizing the disease.

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“…Although juvenile osteochodrosis of the femoral head (Legg-Calvé-Perthes disease) and avascular bone necrosis have been studied extensively for at least 100 years there are still controversies in etiology of the disease and optimal treatment of the condition [1][2][3][4][5][6][7][8]. Changes in the femoral head in Legg-Calvé-Perthes disease and avascular necrosis evaluated with imaging modalities (MSCT, MRI, uS) are well described at different stages of the disease [9][10][11].…”

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confidence: 99%

MRI-semiotics of the gluteal muscles in patients with avascular necrosis of the femoral head and Legg-Calve-Perthes disease

Дьячкова¹,

Teplenky²,

Дьячков³

et al. 2019

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The Declining Incidence of Legg-Calve-Perthes’ Disease in Northern Ireland: An Epidemiological Study

Abstract: Level IV-retrospective cohort study.

Cited by 13 publications

References 20 publications

Declining Rates of Legg–Calvé–Perthes Surgery in the United States: National Trends Using the Kids’ Inpatient Database and Pediatric Health Information System

Declining Rates of Legg–Calvé–Perthes Surgery in the United States: National Trends Using the Kids’ Inpatient Database and Pediatric Health Information System

Aetiology of Legg-Calvé-Perthes disease: A systematic review

MRI-semiotics of the gluteal muscles in patients with avascular necrosis of the femoral head and Legg-Calve-Perthes disease

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