title: Legg-Calvé-Perthes disease at 100: a review of evidence-based treatment.
abstract: BACKGROUND
  The year 2010 is the 100th anniversary of the publication of the first 3 reports describing Legg- Calve-Perthes disease (LCPD). This paper summarizes available evidence previously published and discussed at the several world conferences honoring the occasion.
  
  
  METHODS
  Relevant articles with evidence-based data regarding the efficacy of treatment methods for LCPD were reviewed by the author.
  
  
  RESULTS
  The reviewed studies noted 3 factors related to outcome in patients treated for LCPD as follows: the age at onset, the classification of severity of femoral head involvement, and the type of treatment. In patients over age 8 at onset, surgical treatment with femoral varus osteotomy or Salter innominate osteotomy was associated with improved Stulberg outcomes compared with nonoperative treatment, in those who had lateral pillar B or B/C border class involvement. In the Wiig et al study, patients over age 6 with Catterall 3, 4 classification had better outcomes with these surgical treatment methods compared with nonoperative methods. Children under age 6 at onset had a good prognosis except for a small number of patients between age 4 and 6 years with lateral pillar C involvement.
  
  
  CONCLUSIONS
  There is valid evidence of an association between surgical treatment of certain patients with LCPD and improved radiographic outcome.
authors.affiliation: Texas Scottish Rite Hospital for Children, Dallas, TX 75219, USA. tony.herring@tsrh.org
authors.forename: John Anthony
authors.initials: JA
authors.lastname: Herring
mesh_terms: D000367:Age Factors; D017668:Age of Onset; D002648:Child; D002675:Child, Preschool; D019317:Evidence-Based Medicine; D005270:Femur Head / Q000473:pathology*; D006801:Humans; D007223:Infant; D007873:Legg-Calve-Perthes Disease / Q000145:classification / Q000503:physiopathology / Q000628:therapy*; D010027:Osteotomy / Q000379:methods*; D011379:Prognosis; D012720:Severity of Illness Index; D016896:Treatment Outcome