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Pathophysiology and New Strategies for the Treatment of Legg-Calvé-Perthes Disease

Kim, Harry K.W. MD, MS, FRCSC

Journal of Bone & Joint Surgery - American Volume: 4 April 2012 - Volume 94 - Issue 7 - p 659–669
doi: 10.2106/JBJS.J.01834
Current Concepts Review

Legg-Calvé-Perthes disease is a juvenile form of idiopathic osteonecrosis of the femoral head that can lead to permanent femoral head deformity and premature osteoarthritis.

According to two recent multicenter, prospective cohort studies, current nonoperative and operative treatments have modest success rates of producing a good outcome with a spherical femoral head in older children with Legg-Calvé-Perthes disease.

Experimental studies have revealed that the immature femoral head is mechanically weakened following ischemic necrosis.

Increased bone resorption and delayed new bone formation, in combination with continued mechanical loading of the hip, contribute to the pathogenesis of the femoral head deformity.

Biological treatment strategies to improve the healing process by decreasing bone resorption and stimulating bone formation appear promising in nonhuman preclinical studies.

1Center for Excellence in Hip Disorders, Department of Orthopaedic Surgery, Texas Scottish Rite Hospital for Children, UT Southwestern Medical Center, 2222 Welborn Street, Dallas, TX 75218. E-mail address: Harry.kim@tsrh.org

Copyright 2012 by The Journal of Bone and Joint Surgery, Incorporated
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