title: The long-term prognosis of Legg-Calvé-Perthes disease: a historical prospective study with a median follow-up of forty one years.
abstract: OBJECTIVE
  The purpose of this study is predicting the clinical and radiological long-term outcome and identifying prognostic factors of Legg-Calvé-Perthes disease (LCPD) in Catterall 2 and 3 hips.
  
  
  METHODS
  Sixty hips (59 patients) were diagnosed with LCPD between 1959 to 1974 and were followed prospectively. Forty-two of these 60 hips were classified as Catterall 2 or 3. In 2002, 33 hips (32 patients) with Catterall type 2 or 3 were evaluated clinically and radiographically. In 2010, 27 hips (26 patients) were re-evaluated.
  
  
  RESULTS
  In 2002, 15 hips had Catterall 2 type LCPD and 18 hips Catterall 3. Twelve of the 33 hips (36%) had signs of osteoarthritis. In 2010, 14 hips were classified as Catterall 2 and 13 hips as Catterall 3. Catterall 2 hips had a significantly better Harris Hip Score (HHS) (p = 0.001). There were 15 hips (55%) with signs of osteoarthritis.
  
  
  CONCLUSIONS
  The long-term prognosis of LCPD Catterall type 2 and 3 is relatively benign. However, more than 50% of the patients will develop signs of osteoarthritis between the 4th and 5th decades. At the latest follow-up a strong increase in the number of cases with osteoarthritis was seen. Sphericity of the femoral head is an important predicting factor in the development of osteoarthritis.
authors.affiliation: Department of Orthopaedic Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands, nam_heesakkers@hotmail.com.
authors.forename: Nicole
authors.initials: N
authors.lastname: Heesakkers
authors.forename: Robin
authors.initials: R
authors.lastname: van Kempen
authors.forename: Rhijn
authors.initials: R
authors.lastname: Feith
authors.forename: Jan
authors.initials: J
authors.lastname: Hendriks
authors.forename: Wim
authors.initials: W
authors.lastname: Schreurs
mesh_terms: D017668:Age of Onset; D002648:Child; D002675:Child, Preschool; D005260:Female; D005270:Femur Head / Q000000981:diagnostic imaging; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007873:Legg-Calve-Perthes Disease / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D008297:Male; D015207:Osteoarthritis, Hip / Q000453:epidemiology*; D011183:Postoperative Complications / Q000453:epidemiology*; D011379:Prognosis; D011446:Prospective Studies; D011859:Radiography; D016896:Treatment Outcome