title: Long-term results of total hip replacement in patients with Legg-Calvé-Perthes disease.
abstract: BACKGROUND
  Total hip replacement in patients with Legg-Calvé-Perthes disease can be difficult because of the multiplanar deformities of the proximal part of the femur and previous surgery during childhood. The aim of the present study was to assess the long-term outcomes of total hip replacement in patients who had Legg-Calvé-Perthes disease during childhood.
  
  
  METHODS
  A retrospective study was carried out to assess the results of thirty-two total hip replacements that had been performed for twenty-seven patients from January 1989 to November 2004. The average age at the time of surgery was 37.8 years. The average duration of follow-up was 124 months (range, fifty-eight to 248 months). All but one of the implants were cementless.
  
  
  RESULTS
  There was only one failure in the present study; specifically, the one cemented stem in the study failed two years after surgery. The cumulative survival rate at fifteen years was 96.9% (95% confidence interval, 90.8% to 100.0%). The overall rate of complications was 12.5%, with two permanent sciatic nerve palsies. At the time of the latest follow-up, the average Harris hip score was 87.5 (range, 73 to 96), which was a marked improvement in comparison with the preoperative score (average, 50.1; range, 25 to 75).
  
  
  CONCLUSIONS
  Despite the high rate of neurological complications, possibly related to excessive limb lengthening or inadequate soft-tissue release, total hip replacement can be considered a feasible option for patients with Legg-Calvé-Perthes disease. Careful preoperative planning is advisable in order to overcome the technical pitfalls related to the abnormal proximal femoral and acetabular anatomy of these patients.
authors.affiliation: 1st Department of Orthopaedic Surgery, Rizzoli Orthopaedic Institute, Bologna, Italy. traina@tecno.ior.it
authors.forename: Francesco
authors.initials: F
authors.lastname: Traina
authors.forename: Marcello
authors.initials: M
authors.lastname: De Fine
authors.forename: Alessandra
authors.initials: A
authors.lastname: Sudanese
authors.forename: Pierina Paola
authors.initials: PP
authors.lastname: Calderoni
authors.forename: Enrico
authors.initials: E
authors.lastname: Tassinari
authors.forename: Aldo
authors.initials: A
authors.lastname: Toni
mesh_terms: D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000379:methods*; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D053208:Kaplan-Meier Estimate; D007873:Legg-Calve-Perthes Disease / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D011475:Prosthesis Failure; D016059:Range of Motion, Articular / Q000502:physiology; D012189:Retrospective Studies; D018570:Risk Assessment; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult