title: Legg-Calvé-Perthes disease: role of isolated adductor tenotomy?
abstract: BACKGROUND
  The aim of the study was to compare the radiological results at maturity of patients with Legg-Calve-Perthes disease, treated either by a uniform conservative treatment or by an adductor longus tenotomy.
  
  
  METHODS
  The study cohort comprised 349 hips, mean age 4.4 years. Patients were classified in two different groups depending on the treatment performed. The conservative group (Group I) consisted of 318 hips that had been treated by physical therapy and abduction cast/brace, with a mean age 4.3 years (range 1-10). The tenotomy group (Group II) consisted of 31 hips (treated conservatively but developed an adduction contracture limited to 30°), which had been treated by adductor longus tenotomy with a mean age of 6.2 years (range 2-9). Hip range of motion and radiographic studies were performed at the time of admission. The extent of femoral epiphyseal involvement was assessed at each follow-up by the method of Herring. The final outcomes were assessed at skeletal maturity according to the Stulberg classification system.
  
  
  RESULTS
  Only one patient (two hips) from Group II experienced an improvement in abduction, which was maintained throughout the follow-up until complete the healing of Legg-Calvé-Perthes disease was achieved. In the remaining 29 hips, we observed a progressive loss of ROM previous to 4.3 months from the tenotomy. According to the Stulberg classification, we did not find differences between both groups at final follow-up (p > 0.05).
  
  
  CONCLUSIONS
  These preliminary data suggest that the isolated tenotomy of the adductor longus tendon does not modify the natural evolution of Legg-Calvé-Perthes disease.
authors: Hospital Fremap (Majadahonda), Carretera de Pozuelo 61, Majadahonda, 28220, Madrid, Spain, jmoyaangeler@gmail.com.
authors: Joaquín
authors: J
authors: Moya-Angeler
authors: Juan Carlos
authors: JC
authors: Abril
authors: Ignacio Varo
authors: IV
authors: Rodriguez
mesh_terms: D000704:Analysis of Variance; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007873:Legg-Calve-Perthes Disease / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D012189:Retrospective Studies; D058971:Tenotomy / Q000379:methods*; D016896:Treatment Outcome