title: Shelf acetabuloplasty for Perthes disease in patients older than eight years of age:  an observational cohort study.
abstract: This is a retrospective review of 24 patients with late-onset Perthes disease treated with shelf acetabuloplasty. The mean age of the patients was 9.8 years. The medial joint space ratio improved from 1.66 to 1.47 (P<0.05) and the acetabular cover ratio improved from 0.87 to 1.18 (P<0.001). At maturity, five hips were Stulberg II, 13 were Stulberg III and six were Stulberg IV. The study suggests that shelf acetabuloplasty favourably affects long-term Stulberg grading and therefore outcome compared with historic nonoperative treatment regimens. We believe that the procedure deserves further evaluation in any future randomized-controlled trial of the management of late-onset Perthes disease.
authors.affiliation: Alder Hey Children's Hospital, Eaton Road, Liverpool, UK. dmmwright@hotmail.com
authors.forename: David M
authors.initials: DM
authors.lastname: Wright
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Perry
authors.forename: Colin E
authors.initials: CE
authors.lastname: Bruce
mesh_terms: D000077:Acetabulum / Q000000981:diagnostic imaging / Q000601:surgery*; D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007873:Legg-Calve-Perthes Disease / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D019637:Orthopedic Procedures / Q000379:methods; D010027:Osteotomy / Q000379:methods*; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D020127:Recovery of Function; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome