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The long-term prognosis of Legg-Calvé-Perthes disease: a historical prospective study with a median follow-up of forty one years

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Abstract

Purpose

The purpose of this study is predicting the clinical and radiological long-term outcome and identifying prognostic factors of Legg-Calvé-Perthes disease (LCPD) in Catterall 2 and 3 hips.

Methods

Sixty hips (59 patients) were diagnosed with LCPD between 1959 to 1974 and were followed prospectively. Forty-two of these 60 hips were classified as Catterall 2 or 3. In 2002, 33 hips (32 patients) with Catterall type 2 or 3 were evaluated clinically and radiographically. In 2010, 27 hips (26 patients) were re-evaluated.

Results

In 2002, 15 hips had Catterall 2 type LCPD and 18 hips Catterall 3. Twelve of the 33 hips (36 %) had signs of osteoarthritis. In 2010, 14 hips were classified as Catterall 2 and 13 hips as Catterall 3. Catterall 2 hips had a significantly better Harris Hip Score (HHS) (p = 0.001). There were 15 hips (55 %) with signs of osteoarthritis.

Conclusion

The long-term prognosis of LCPD Catterall type 2 and 3 is relatively benign. However, more than 50 % of the patients will develop signs of osteoarthritis between the 4th and 5th decades. At the latest follow-up a strong increase in the number of cases with osteoarthritis was seen. Sphericity of the femoral head is an important predicting factor in the development of osteoarthritis.

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References

  1. Catterall A (1971) The natural history of Perthes’ disease. J Bone Joint Surg (Br) 53:37–53

    CAS  Google Scholar 

  2. Fulford GE, Lunn PG, Macnicol MF (1993) A prospective study of nonoperative and operative management for Perthes’ disease. J Pediatr Orthop 13:281–285

    Article  CAS  PubMed  Google Scholar 

  3. Mukherjee A, Fabry G (1990) Evaluation of the prognostic indices in Legg-Calve-Perthes disease: Statistical analysis of 116 hips. J Pediatr Orthop 10:153–158

    Article  CAS  PubMed  Google Scholar 

  4. Ippolito E, Tudisco C, Farsetti P (1987) The long-term prognosis of unilateral Perthes’ disease. Clin Orthop Relat Res 69:243–250

    CAS  Google Scholar 

  5. Fabry K, Fabry G, Moens P (2003) Legg-Calve-Perthes disease in patients under 5 years of age does not always result in a good outcome Personal experience and meta-analysis of the literature. J Pediatr Orthop B 12:222–227

    PubMed  Google Scholar 

  6. McAndrew MP, Weinstein SL (1984) A long-term follow-up of Legg-Calve-Perthes disease. J Bone Joint Surg Am 66:860–869

    CAS  PubMed  Google Scholar 

  7. Wiig O, Terjesen T, Svenningsen S (2008) Prognostic factors and outcome of treatment in Perthes’ disease: A prospective study of 368 patients with five-year follow-up. J Bone Joint Surg (Br) 90:1364–1371

    Article  CAS  Google Scholar 

  8. Yrjonen T (1999) Long-term prognosis of Legg-Calve-Perthes disease: A meta-analysis. J Pediatr Orthop B 8:169–172

    Article  CAS  PubMed  Google Scholar 

  9. Weinstein SL (1997) Natural history and treatment outcomes of childhood hip disorders. Clin Orthop Relat Res 344:227–242

    Article  PubMed  Google Scholar 

  10. Mose K, Hjorth L, Ulfeldt M, Christensen ER, Jensen A (1977) Legg Calve Perthes disease. The late occurence of coxarthrosis. Acta Orthop Scand Suppl 169:1–39

    CAS  PubMed  Google Scholar 

  11. Stulberg SD, Cooperman DR, Wallensten R (1981) The natural history of Legg-Calve-Perthes disease. J Bone Joint Surg Am 63:1095–1108

    CAS  PubMed  Google Scholar 

  12. Kellgren JH, Lawrence JS (1957) Radiological assessment of osteo-arthrosis. Ann Rheum Dis 16:494–502

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  13. Christensen F, Soballe K, Ejsted R, Luxhoj T (1986) The Catterall classification of Perthes’ disease: An assessment of reliability. J Bone Joint Surg (Br) 68:614–615

    CAS  Google Scholar 

  14. Ritterbusch JF, Shantharam SS, Gelinas C (1993) Comparison of lateral pillar classification and Catterall classification of Legg-Calve-Perthes’ disease. J Pediatr Orthop 13:200–202

    CAS  PubMed  Google Scholar 

  15. Froberg L, Christensen F, Pedersen NW, Overgaard S (2011) The need for total hip arthroplasty in Perthes disease: A long-term study. Clin Orthop Relat Res 469:1134–1140

    Article  PubMed Central  PubMed  Google Scholar 

  16. Gower WE, Johnston RC (1971) Legg-Perthes disease. Long-term follow-up of thirty-six patients. J Bone Joint Surg Am 53:759–768

    CAS  PubMed  Google Scholar 

  17. Lecuire F (2002) The long-term outcome of primary osteochondritis of the hip (Legg-Calve-Perthes’ disease). J Bone Joint Surg (Br) 84:636–640

    Article  CAS  Google Scholar 

  18. Perpich M, McBeath A, Kruse D (1983) Long-term follow-up of Perthes disease treated with spica casts. J Pediatr Orthop 3:160–165

    Article  CAS  PubMed  Google Scholar 

  19. Yrjonen T (1992) Prognosis in Perthes’ disease after noncontainment treatment. 106 hips followed for 28-47 years. Acta Orthop Scand 63:523–526

    Article  CAS  PubMed  Google Scholar 

  20. Norlin R, Hammerby S, Tkaczuk H (1991) The natural history of Perthes’ disease. Int Orthop 15:13–16

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

We declare that we have no conflict of interest

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands

    Nicole Heesakkers, Rhijn Feith & Wim Schreurs

  2. Department of Orthopaedic Surgery, Catharina Hospital, Radboud University Medical Centre, Nijmegen, The Netherlands

    Robin van Kempen

  3. Department of Epidemiology and Biostatistics, Radboud University Medical Centre, Nijmegen, The Netherlands

    Jan Hendriks

Authors
  1. Nicole Heesakkers
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  2. Robin van Kempen
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  3. Rhijn Feith
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  4. Jan Hendriks
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  5. Wim Schreurs
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Correspondence to Nicole Heesakkers.

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Heesakkers, N., van Kempen, R., Feith, R. et al. The long-term prognosis of Legg-Calvé-Perthes disease: a historical prospective study with a median follow-up of forty one years. International Orthopaedics (SICOT) 39, 859–863 (2015). https://doi.org/10.1007/s00264-014-2589-2

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  • DOI: https://doi.org/10.1007/s00264-014-2589-2

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