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Total Hip Arthroplasty for the Sequelae of Legg-Calvé-Perthes Disease

  • Clinical Research
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

The durability and risks associated with total hip arthroplasty (THA) for patients with a history of Legg-Calvé-Perthes disease (LCPD) are not well known.

Questions/purpose

We sought to (1) determine the survivorship of THAs performed for LCPD; (2) assess hip scores and complications associated with THA in this patient population; and (3) compare results between patients who had undergone surgery in childhood with patients who had conservative treatment.

Methods

We reviewed 99 primary THAs performed in 95 patients with a history of LCPD with minimum 2-year followup (mean ± SD, 8 ± 5 years). Mean age at THA was 48 ± 15 years.

Results

A total of 10 revisions were performed. Using revision for any reason as the end point, the 8-year survival rate was 90% (95% confidence interval [CI], 76%–96%) for cementless implants compared with 86% (95% CI, 57%–96%) for hybrid implants. The mean Harris hip score improved by 31 ± 16 (n = 76). Complications occurred in 16% of hips. The most common major complication was intraoperative fracture (eight femoral, one acetabular). Three patients developed sciatic nerve palsy after a mean lengthening of 2.2 ± 1 cm compared with a mean of 1.4 ± 1 cm in patients with intact sciatic nerve (p = 0.3).

Conclusions

Cementless THAs for the sequelae of LCPD demonstrate 90% survival from any revision at 8 years followup. THAs for the sequelae of LCPD can be complicated and technically difficult. Intraoperative fractures and nerve injuries are common. Care should be taken to avoid excessive limb lengthening.

Level of Evidence

Level IV, retrospective case series. See Guidelines for Authors for a complete description of levels of evidence.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA

    Yaser M. K. Baghdadi MD, A. Noelle Larson MD, Anthony A. Stans MD & Tad M. Mabry MD

Authors
  1. Yaser M. K. Baghdadi MD
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  2. A. Noelle Larson MD
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  3. Anthony A. Stans MD
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  4. Tad M. Mabry MD
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Corresponding author

Correspondence to A. Noelle Larson MD.

Additional information

One of the authors (TMM) is a consultant for Zimmer (Warsaw, IN, USA).

All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request.

Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

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Baghdadi, Y.M.K., Larson, A.N., Stans, A.A. et al. Total Hip Arthroplasty for the Sequelae of Legg-Calvé-Perthes Disease. Clin Orthop Relat Res 471, 2980–2986 (2013). https://doi.org/10.1007/s11999-013-3006-7

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  • DOI: https://doi.org/10.1007/s11999-013-3006-7

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