Accepted for/Published in: Interactive Journal of Medical Research
Date Submitted: Jan 10, 2021
Date Accepted: Apr 11, 2021
Surgical treatments in Legg-Calvé-Perthes disease: A comprehensive review
ABSTRACT
Background:
Legg–Calvé–Perthes disease (LCPD) is a common public health problem that commonly occurred between the ages of 4 and 8 years while it can found between the ages of 2 and 15 years old. This condition occurred due to the interruption of blood supply to the femoral head. Up to now, different surgical and non-surgical treatments have been suggested for non-containable LCPD hips including femoral varus osteotomy, innominate osteotomy, pelvic osteotomies, triple osteotomy, Chiari osteotomy, shelf acetabuloplasty.
Objective:
The aim of this comprehensive review was to investigate the various surgical techniques used in Legg-Calvé-Perthes disease.
Methods:
An advanced electronic search of the English-language literature was done on October 8-14, 2020. The electronic databases PUBMED, MEDLINE, Web of Science, EMBASE, OVID and Google scholar were searched using appropriate search terms. A manual search of references also was done. After retrieving the studies, duplicates were removed, then the reminder were screened based on the title, abstract and full text. The selected articles were quality assessed and the required data were extracted from eligible ones.
Results:
A total of 22 studies were included in the review. Based on the results of reviewed studies there are three main factors, which influencing the treatments outcomes in patients with Perthes disease. These factors are including the onset age, femoral head involvement severity as well as the treatment method. The disease has a poor prognosis in children over 8 years old but this group of patients can also benefit from advanced surgical methods. In patients less than 6 years, the disease has a generally good prognosis but in the ages between 6 and 8 years its prognosis is variable, so the need for surgical intervention requires close observation of signs. Once any head signs are observed, a dynamic arthrography is beneficial before choosing the treatment technique.
Conclusions:
This review provides a brief guideline for clinicians in treating the Legg-Calvé-Perthes patients.
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