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Legg-Calvé-Perthes Disease, Sports Medicine

Christopher McGrew, MD, FACSM, CAQSM Reviewed 04/2019
 


BASICS

DESCRIPTION

  • Juvenile idiopathic avascular necrosis of the capital femoral epiphysis of the femoral head

  • Synonym(s): Perthes disease; aseptic necrosis of the femoral head; osteochondritis deforman...

DIAGNOSIS

HISTORY

Symptoms of LCPD usually have been present for weeks because the child often does not complain: 
  • Limp worsened by activity, usually most pronounced at end of day (may be painless)

  • Hip o...

TREATMENT

GENERAL MEASURES

  • The healing process involves revascularization of the femoral head, removal of necrotic bone, and replacement with viable bone. It is a biologic process that requires many mo...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

All patients with suspected LCPD should be referred to a pediatric orthopedic surgeon promptly. 

PROGNOSIS

  • The younger the age of onset of LCPD, the better is the p...

REFERENCES

1
Berthaume MA, Perry DC, Dobson CA, et al. Skeletal immaturity, rostral sparing, and disparate hip morphologies as biomechanical causes for Legg-Calvé-Perthes’ disease. Clin Anat.  201...

ADDITIONAL READING

  • Ibrahim T, Little DG. The pathogenesis and treatment of Legg-Calvé-Perthes disease. JBJS Rev.  2016;4(7). doi:10.2106/JBJS.RVW.15.00063.

  • Johansson T, Lindblad M, Bladh M, et al....

CLINICAL PEARLS

  • Etiology of LCPD is unclear.

  • Treatment courses vary widely among patients, and close follow-up is essential.

  • Both surgical and nonsurgical treatments are aimed at symptom reduction, prev...

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