Contrary to our prior understanding, this study by Larson et al. suggests an entirely different long-term prognosis for Perthe’s hip. At an average of twenty years of follow-up, more than half of the patients had signs of impingement on examination, 76% had intermittent hip pain, almost 40% complained of hip pain at least several times weekly.
Validated outcome measures revealed that only about 50% of the patients had good to excellent clinical and radiographic results at twenty-two to thirty-five years of age, a period in life when one expects excellent musculoskeletal function.
It is likely that this study will further encourage the current trend in the treatment of LCP disease, which includes more aggressive containment treatment for younger children and “hip preservation surgery” for teenagers and young adults with continuing symptoms.
Whether this pattern will be a wise one remains to be seen..
Larson AN, Sucato DJ, Herring JA, et al. A prospective multicenter study of Legg-Calvé-Perthes disease: functional and radiographic outcomes of nonoperative treatment at a mean follow-up of twenty years. J Bone Joint Surg Am. 2012 Apr 4;94(7):584-92.