From the Research
Legg-Calvé-Perthes disease should be treated with surgical interventions such as femoral varus osteotomy (FVO), Salter's innominate osteotomy (SIO), or triple pelvic osteotomy (TPO) to improve the containment of the femoral head and restore the function of the hip joint, especially in moderate to severe cases or in children over 6 years old, as recommended by the most recent study 1. The goal of treatment for Legg-Calvé-Perthes disease is to maintain or restore the containment of the affected hip joint, and the specific treatment depends on the patient's age at onset, the stage, and severity of the disease.
- For early stages of the disease, containment-restoring procedures such as FVO, SIO, or TPO are commonly used 1.
- In moderate forms of the disease, FVO or SIO can provide good outcomes, while severe cases may require FVO combined with SIO or TPO 1.
- In later stages with increased damage to the femoral head, non-containment-restoring procedures such as femoral valgus extension osteotomy or trochanter apophyseodesis may be considered to help with symptom relief or restore anatomical and biomechanical features 1. It is essential to consult with an experienced surgeon in pediatric orthopedics to determine the best treatment course for the patient, as the complexity of surgical interventions and the challenging nature of Legg-Calvé-Perthes disease require individualized treatment plans 1. The prognosis is generally better for younger children and those with less femoral head involvement, and long-term complications may include early osteoarthritis and leg length discrepancy, emphasizing the importance of regular monitoring through skeletal maturity 2, 3. Pain management with NSAIDs like ibuprofen may be needed during active disease phases, and physical therapy to maintain range of motion is essential regardless of severity 4.