Long-term results of proximal femoral osteotomy in Legg-Calvé-Perthes disease.
BACKGROUND
Legg-Calvé-Perthes disease is a childhood hip disorder that may result in a deformed and poorly functioning hip. The purpose of this study was to evaluate the correlation between hip deformity at skeletal maturity and degenerative osteoarthritis and to present the long-term results of proximal femoral varus derotational osteotomy in Legg-Calvé-Perthes disease.


METHODS
We analyzed the results of 40 patients (43 hips), who underwent proximal femoral varus derotational osteotomy for Legg-Calvé-Perthes disease in our institution between 1959 and 1983. All available patients underwent a single long-term follow-up examination. Hips were classified with the classification system of Stulberg. Osteoarthritis was evaluated using the Tönnis classification. The long-term outcomes were evaluated after a mean follow-up period of 33 years.


RESULTS
When examining the outcome using the Stulberg classification system, there were 8 Stulberg class I hips (19.5%), 15 Stulberg class II hips (36.6%), 8 Stulberg class III hips (19.5%), 9 Stulberg class IV hips (22%), and 1 Stulberg class V hip (2.4%). One patient, who had a bilateral Legg-Calvé-Perthes disease, underwent total hip replacement for osteoarthritis. Seven patients had poor clinical results.


CONCLUSIONS
Proximal femoral varus derotational osteotomy provides good long-term results for Legg-Calvé-Perthes disease. The Stulberg classification is a good predictor for patient outcome.


METHODS
Level IV, therapeutic study.
Beer
Yiftah
Y
Department of Orthopedic Surgery, Schneider Children's Medical Center, Petah Tikva, Israel.
Smorgick
Yossi
Y
Oron
Amir
A
Mirovsky
Yigal
Y
Weigl
Danny
D
Agar
Gabriel
G
Shitrit
Reuven
R
Copeliovitch
Leonel
L
D000293:Adolescent; D000328:Adult; D000365:Age Determination by Skeleton; D019644:Arthroplasty, Replacement, Hip; D002648:Child; D002675:Child, Preschool; D005260:Female; D005270:Femur Head / Q000473:pathology / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007873:Legg-Calve-Perthes Disease / Q000145:classification / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000209:etiology* / Q000503:physiopathology; D010027:Osteotomy / Q000379:methods*; D012720:Severity of Illness Index; D016896:Treatment Outcome