title: Clinical and radiographic outcomes after femoral varus derotation osteotomy for Legg-Calvé-Perthes disease at 25 years follow-up: what are the determinants of outcome in the long term?
abstract: OBJECTIVE
  The main purposes of the present study were to analyse the long-term clinical and radiographic results of femoral varus derotation osteotomy performed in a group of patients with the diagnosis of Legg-Calvé-Perthes (LCP) disease and to compare the effects of age, lateral pillar classification, radiographic stage according to Waldenström's classification, and the amount of varisation obtained on long-term results.
  
  
  METHODS
  The study group consisted of 21 hips. The mean postoperative follow-up time was 25.1 years. The effect of age at the time of surgery, preoperative lateral pillar classification, Waldenström's classification, and the amount of varisation on Merle d'Aubigne score, Stulberg class, and presence of degenerative arthritis of the hip joint were assessed at the final follow-up.
  
  
  RESULTS
  Better clinical and radiographic outcomes were detected in patients operated younger than 10 years. The hips with lateral pillar group C involvement preoperatively were found to be significantly associated with worse clinical scores, worse radiographic outcome, and higher rate of degenerative arthritis. The overall rate of the hips with good radiologic outcome was 52.4%. 7 hips had degenerative arthritis at the final follow-up.
  
  
  CONCLUSIONS
  Femoral varus derotation osteotomy revealed a congruent joint in half of the operated hips and arthritis-free hip joint in 2/3 at 25 years follow-up. Age at the time of surgery and preoperative lateral pillar classification were the main determinants of the radiographic outcome whereas the factors significantly correlated with progression to degenerative arthritis were determined preoperative lateral pillar classification and Stulberg group at maturity.
authors: Selcuk University Faculty of Medicine, Konya - Turkey.
authors: Bahattin K
authors: BK
authors: Aydin
authors: Erzincan University Faculty of Medicine, Erzincan - Turkey.
authors: Hakan
authors: H
authors: Sofu
authors: Afyon Kocatepe University Faculty of Medicine, Afyon - Turkey.
authors: Mehmet N
authors: MN
authors: Konya
authors: Baltalimani Bone and Joint Diseases Hospital, Istanbul - Turkey.
authors: Turgay
authors: T
authors: Er
authors: Erzincan University Faculty of Medicine, Erzincan - Turkey.
authors: Vedat
authors: V
authors: Sahin
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D015331:Cohort Studies; D018450:Disease Progression; D005269:Femur / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D007873:Legg-Calve-Perthes Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery*; D008991:Monitoring, Physiologic / Q000379:methods; D010027:Osteotomy / Q000009:adverse effects / Q000379:methods*; D010147:Pain Measurement; D011859:Radiography / Q000379:methods; D016059:Range of Motion, Articular / Q000502:physiology*; D012189:Retrospective Studies; D018570:Risk Assessment; D012737:Sex Factors; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult