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Journal of Pediatric Orthopaedics:
doi: 10.1097/BPO.0b013e318223b52d

Legg-Calvé-Perthes Disease at 100: A Review of Evidence-based Treatment

Herring, John Anthony MD*,†

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Background: The year 2010 is the 100th anniversary of the publication of the first 3 reports describing Legg- Calve-Perthes disease (LCPD). This paper summarizes available evidence previously published and discussed at the several world conferences honoring the occasion.

Methods: Relevant articles with evidence-based data regarding the efficacy of treatment methods for LCPD were reviewed by the author.

Results: The reviewed studies noted 3 factors related to outcome in patients treated for LCPD as follows: the age at onset, the classification of severity of femoral head involvement, and the type of treatment. In patients over age 8 at onset, surgical treatment with femoral varus osteotomy or Salter innominate osteotomy was associated with improved Stulberg outcomes compared with nonoperative treatment, in those who had lateral pillar B or B/C border class involvement. In the Wiig et al study, patients over age 6 with Catterall 3, 4 classification had better outcomes with these surgical treatment methods compared with nonoperative methods. Children under age 6 at onset had a good prognosis except for a small number of patients between age 4 and 6 years with lateral pillar C involvement.

Conclusions: There is valid evidence of an association between surgical treatment of certain patients with LCPD and improved radiographic outcome.

Level of evidence: Level II.

© 2011 Lippincott Williams & Wilkins, Inc.

The Pediatric Orthopaedic Society of North America (POSNA)
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