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We just took in a foster child who has Legg-Calvé-Perthes disease. He is 12 years old. Is it too late to help him with treatment?

Legg-Calvé-Perthes disease is a condition that first affects the hip in children between the ages of four and eight. The name is in honor of the three physicians who each separately described the disease.

In this condition, the blood supply to the growth center of the hip is disturbed. This area is called the capital femoral epiphysis. The loss of blood supply causes the bone in this area to die.

Blood eventually returns, and the bone heals. How the bone heals determines how much problem the condition will cause in later life. This condition can lead to serious problems in the hip joint later in life.

Most experts agree that treatment before the age of eight gives the best result. The goal is to keep the head of the femur in the acetabulum (hip socket) and to maintain a nice, round ball shape to this part of the bone.

But the few studies done on children who received treatment later in life have also shown some good results. The femoral head must be held in the joint socket as much as possible. This treatment is called containment.

It is better if the hip is allowed to move and is not held completely still in the acetabulum. Joint motion is necessary for nutrition of the cartilage and for healthy growth of the joint. The healing process can take several years.

Sometimes surgery is needed for children who are diagnosed with this disease later in life. Surgical treatment for containment usually consists of procedures that realign either the femur (thighbone), the acetabulum (hip socket), or both.

Once the child has been seen by an orthopedic surgeon, a plan of care can be established.

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