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Cheilectomy Doesn't Prevent Osteoarthritis in Legg-Calve-Perthes Disease
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Posted on: 04/13/2006
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In this study doctors report the results of five cases of Legg-Calve-Perthes disease treated with cheilectomy. Cheilectomy is the partial removal of the femoral head. The femoral head is the round ball of bone at the top of the femur (thighbone) that normally fits into the hip socket.
Loss of blood supply to the hip from Perthes disease causes the femoral head to flatten and collapse. A flat, instead of round, femoral head can slip out of the hip socket causing partial dislocation called subluxation. Complete dislocation is also possible.
Cheilectomy used on five patients had good short-term results. Everyone had less pain and improved motion. Three of the five patients stopped limping completely. The other two limped much less.
But the good results didn't last. When the patients were in their early 30s osteoarthritis (OA) developed. X-rays showed a narrowed joint space and bone spurs. Hip pain and leg length differences caused four of the five to start limping again. Range of motion was better than before surgery but much worse than during the early years after the operation.
Cheilectomy isn't a common way to treat Perthes disease. Reports of results are rare. The results of this study show that cheilectomy doesn't prevent hip OA in patients with Perthes disease.
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References:
Sung Man Rowe, MD, et al. Outcome of Cheilectomy in Legg-Calve-Perthes Disease. Minimum 25-Year Follow-Up of Five Patients. In Journal of Pediatric Orthopaedics. March/April 2006. Vol. 26. No. 2. Pp. 204-210.
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