Child Orthopedics

Frequently Asked Questions

We are looking for any information you might have on the prognosis of Legg-Perthes disease. We have a child newly diagnosed with this condition.

The goal of treatment is to avoid preserve the bone mass, shape, and function until the disease runs its full course. Modern treatment with pressure reduction on the joint along with physical therapy to maintain joint motion, strength, and function is effective for many children. Doing specific exercises during the healing process ensures that the femur and hip socket are smooth and glide smoothly. The program minimizes the long-term effects of the disease. Treatment also focuses on activity modification (no extreme or running sports) and using crutches to offload the joint. Orthoses (braces) to properly position the hip and help relieve the joint of the body's weight may be needed. This gives the top of the femur room to regrow and shape better. In some cases, surgery is recommended. Currently, there are studies conducted on medications to prevent bone resorption for the treatment of Perthes. Pain relievers may be given as needed. Close management and follow-up with an orthopedic surgeon is crucial. Younger children have a better prognosis than older children. Perthes is a long-term problem. There's no cure but the damaging effects of the disease can be minimized. As these children age, problems in the knee and back can develop. The acetabulum (hip socket) can develop an abnormal shape and angle. Osteoarthritis is very common because of the uneven wear in the damaged hip. Adults over the age of 50 with a history of Perthes disease have a higher incidence of hip joint replacement compared with adults the same age who did not have Perthes. With continued studies and new knowledge gained, treatment results may improve. Children born with this disease today will have a much better outcome than even 10 years ago.

Wudbhav N. Sankar, MD, and John M. Flynn, MD. The Development of Acetabular Retroversion in Children With Legg-Calvé-Perthes Disease. In Journal of Pediatric Orthopaedics. June 2008. Vol. 28. No. 4. Pp. 440-443.

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