Vidal-Ruiz CA, Barajas-Olivos AG, Castañeda-Leeder P

Language: Spanish
References: 11
Page: 33-37
PDF size: 51.52 Kb.

ABSTRACT

Background: Lateral pillar classification has proven to be useful for the prognosis and treatment of patients with Legg-Calvé-Perthes disease. Most patients progress to skeletal maturity with some kind of morphologic alteration. Femoroacetabular impingement is a condition that results in early osteoarthrosis. The objective of this study was to determine whether there is a correlation between the initial lateral pillar classification and the presence of final femoroacetabular impingement. Material and methods: A retrospective review of 61 patients with Legg-Calvé-Perthes disease was conducted (68 hips); they were classified into three groups according to the lateral pillar classification. At the time of skeletal maturity the radiographic presence of femoroacetabular impingement was determined and the correlation between both variables was analyzed. Results: The use of the lateral pillar classification resulted in seven hips considered as type A, 37 as type B, and 24 as type C. Three of the type A hips had radiographic findings of cam femoroacetabular impingement, three of pincer femoroacetabular impingement, and one of mixed femoroacetabular impingement. Among type B hips, radiographic data of cam femoroacetabular impingement were found in 17, of pincer femoroacetabular impingement in 12, and of mixed femoroacetabular impingement in 10. Twenty-three of the type C hips had radiographic data of cam femoroacetabular impingement, 15 of pincer femoroacetabular impingement, and 15 of mixed femoroacetabular impingement. Conclusion: Patients with Legg-Calvé-Perthes disease have a directly proportional relationship between the initial lateral pillar classification and subsequent femoroacetabular impingement.

REFERENCES

1. Skaggs D, Tolo V, et al: Legg-Calvé-Perthes Disease. J Am Acad Orthop Surg 1996; 4(1): 9-16.

2. Evans D, et al: Legg-Calvé-Perthes disease, a study of late results. J Bone and Joint Surg 1958; 40-B(2): 168-81.

3. Stulberg D, Cooperman D, et al: The Natural History of Legg Calvé Perthes Disease. J Bone and Joint Surg 1981; 63-A(7): 1095-1108.

4. Hresko T, McDougall P, et al: Prospective Reevaluation of the Association Between Thrombotic Diathesis and Legg-Perthes Disease. J Bone and Joint Surg 2002; 84-A(9): 1613-8.

5. Farsetti P, Tudisco C, et al: The Herring lateral pillar classification for Perthes disease. J Bone Joint Surg 1995; 77: 739-42.

6. Gallistl S, Reitinger T, et al: The role of inherited thrombotic disorders in the etiology of Legg-Calvé-Perthes Disease. J Pediatr Orthop 1999; 19: 82-3.

7. Rowe SM, Jung ST, et al: The incidence of Perthes disease in Korea, a focus on difference among races. J Bone Joint Surg Br 2005; 87: 1666-87.

8. Kalenderer O, Agus H, et al: The importance of surgeons experience on intraobserver and interobserver reliability of classifications used on Perthes disease. J Pediatr Orthop 2005; 25: 460-4.

9. Herring JA, Neustradt JB, et al: The lateral pillar classification of Legg-Calvé-Perthes disease. J Pediatr Orthop 1992; 12: 143-50.

10. Gent E, Antapur P, et al: Perthe´s disease in the young child. J Pediatr Orthop B 2006; 15: 16-22.

11. Catterall A: The natural History of Perthe´s disease. J Bone Joint Surg 1971; 53B: 37.