Perthes Disease
What is Perthes Disease?
Perthes disease, also known as Legg-Calve-Perthes disease, is a childhood condition characterized by a temporary loss of blood supply to the head of the femur (the hip bone).
Without adequate blood flow, the bone cells undergo avascular necrosis, leading to cell death. This is followed by a regeneration and healing process. However, when blood supply returns to the femur, while it can strengthen the bone, the shape may become permanently distorted. If the femur fails to heal properly, it can result in pain, stiffness, and complications such as arthritis.
Causes of Perthes Disease
Although the exact cause of Perthes disease is idiopathic, it occurs more frequently in males and children aged 4 to 12 years.
Symptoms of Perthes Disease
In the early stages of the disease, some noticeable symptoms include:
- Pain in the hip area, groin, thigh, or knee
- A painful limp
- Stiffness or decreased motion in the hip joint
- Painful muscle spasms
- Aggravated pain during activities, relieved by rest
However, Perthes disease can also present in the later years. Symptoms may include:
- Shortening of the limb (limb length discrepancy)
- Decreased range of movement
- Altered walking pattern
How Does It Affect Your Child?
Children with Perthes disease have an increased risk of developing hip arthritis in adulthood, especially if the hip joint fails to heal properly. If the disease progresses without intervention, the femur may heal in a deformed shape, leading to an irregular head. This joint deformity can predispose the child to early osteoarthritis of the hip joint. Therefore, early diagnosis is crucial to prevent the disease from progressing and to minimize long-term complications.
Treatment Options
The aim of treating Perthes disease is to allow the hip joint to develop as normally as possible, relieve painful symptoms, and protect the shape of the femoral head. Treatment options depend on the child’s age, severity of the damage, and stage of the disease.
Non-surgical treatments
Non-surgical treatments may help relieve symptoms and are suitable for patients under the age of 8. Treatment options include:
- Medication to relieve pain and inflammation
- Physical therapy to address hip stiffness
- Casting or bracing
Surgical treatments
Surgery may be recommended to properly align the bone, particularly for children over 8 years old or if conservative methods fail to maintain the hip’s position for healing.
Osteotomy is a surgical procedure for treating Perthes disease. During this procedure, the bone is cut and repositioned to keep the femoral head within the acetabulum (hip socket). Screws and plates are used to maintain alignment and are removed once the bones have healed.