title: Total hip arthroplasty for the sequelae of Legg-Calvé-Perthes disease.
abstract: BACKGROUND
  The durability and risks associated with total hip arthroplasty (THA) for patients with a history of Legg-Calvé-Perthes disease (LCPD) are not well known.
  
  
  OBJECTIVE
  We sought to (1) determine the survivorship of THAs performed for LCPD; (2) assess hip scores and complications associated with THA in this patient population; and (3) compare results between patients who had undergone surgery in childhood with patients who had conservative treatment.
  
  
  METHODS
  We reviewed 99 primary THAs performed in 95 patients with a history of LCPD with minimum 2-year followup (mean ± SD, 8 ± 5 years). Mean age at THA was 48 ± 15 years.
  
  
  RESULTS
  A total of 10 revisions were performed. Using revision for any reason as the end point, the 8-year survival rate was 90% (95% confidence interval [CI], 76%-96%) for cementless implants compared with 86% (95% CI, 57%-96%) for hybrid implants. The mean Harris hip score improved by 31 ± 16 (n = 76). Complications occurred in 16% of hips. The most common major complication was intraoperative fracture (eight femoral, one acetabular). Three patients developed sciatic nerve palsy after a mean lengthening of 2.2 ± 1 cm compared with a mean of 1.4 ± 1 cm in patients with intact sciatic nerve (p = 0.3).
  
  
  CONCLUSIONS
  Cementless THAs for the sequelae of LCPD demonstrate 90% survival from any revision at 8 years followup. THAs for the sequelae of LCPD can be complicated and technically difficult. Intraoperative fractures and nerve injuries are common. Care should be taken to avoid excessive limb lengthening.
authors: Department of Orthopedic Surgery, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, USA.
authors: Yaser M K
authors: YM
authors: Baghdadi
authors: A Noelle
authors: AN
authors: Larson
authors: Anthony A
authors: AA
authors: Stans
authors: Tad M
authors: TM
authors: Mabry
mesh_terms: D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip; D006622:Hip Prosthesis; D006801:Humans; D007873:Legg-Calve-Perthes Disease / Q000601:surgery*; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000601:surgery*; D011474:Prosthesis Design; D016059:Range of Motion, Articular; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
references: J Bone Joint Surg Br. 1987 Jan;69(1):45-55
references: 3818732
references: J Bone Joint Surg Am. 2012 Apr 4;94(7):584-92
references: 22488614
references: J Bone Joint Surg Am. 2004 Oct;86(10):2121-34
references: 15466720
references: J Bone Joint Surg Am. 2005 Oct;87(10):2323-34
references: 16203901
references: J Bone Joint Surg Am. 1994 Mar;76(3):448-58
references: 8126052
references: J Bone Joint Surg Am. 2009 Sep;91(9):2213-21
references: 19723999
references: Clin Orthop Relat Res. 1979 Jun;(141):17-27
references: 477100
references: Clin Orthop Relat Res. 1997 Nov;(344):61-8
references: 9372758
references: Acta Orthop. 2008 Dec;79(6):769-76
references: 19085493
references: J Bone Joint Surg Am. 2011 Apr 6;93(7):e25
references: 21471405
references: J Bone Joint Surg Am. 2001 Dec;83(12):1865-70
references: 11741067
references: Orthop Rev. 1986 Sep;15(9):561-74
references: 3331009
references: J Bone Joint Surg Br. 2008 Oct;90(10):1364-71
references: 18827249
references: Clin Orthop Relat Res. 1988 Mar;(228):105-9
references: 3342551
references: J Bone Joint Surg Am. 1981 Sep;63(7):1095-108
references: 7276045
references: J Bone Joint Surg Am. 2005 Dec;87(12):2619-2625
references: 16322610
references: J Pediatr Orthop. 2004 Mar-Apr;24(2):235-40
references: 15076614
references: J Pediatr Orthop. 2011 Sep;31(2 Suppl):S137-40
references: 21857427
references: J Bone Joint Surg Am. 2012 Dec 5;94(23):2153-9
references: 23224386
references: J Bone Joint Surg Am. 1969 Jun;51(4):737-55
references: 5783851
references: BMC Musculoskelet Disord. 2013 Jan 22;14:37
references: 23339294