Perthes disease, also known as Legg-Calve-Perthes, affects children between the ages of four and ten. While it is five times more common in boys than in girls, it is more likely to cause bone damage in girls. Both hips are affected in ten percent to fifteen percent of all cases. The cause of Perthes disease is not known. So, parents must visit a pediatric orthopedic doctor in Gurgaon for proper diagnosis and treatment.
During this stage, the blood flow to the head of the femur is compromised, and bone cells die. The affected area will become inflamed or irritated. Also, the child will begin to show symptoms of the disease, including limping and differences in walking. This preliminary stage could last for many months.
The body removes the dead bone underneath the articular cartilage and quickly replaces it with a new, softer bone within a period of 1 to 2 years. The bone is weaker during this process, and the femur head might fall into a flatter position.
In the head of the femur, new, stronger bone forms and takes shape. The reossification stage of the disease is always the longest, lasting many years.
The bone regrowth is completed at this stage, and it starts to take shape in the head of the femur. The extent of damage during the fragmentation process, and the child’s age at the onset of disease, determines how similar the shape is to round. These factors also affect the potential for bone regrowth.
A shift in the child’s walking and running style is one of the first symptoms of Perthes. This is most noticeable when participating in sports. The child can limp, have limited motion, or develop an unusual running style because of irritability in the hip joint.
Some other symptoms include:
Symptoms can come and go over weeks or even months, depending on the child’s activity level.
Perthes disease can be treated in several ways.
Treatment of Perthes disease aims to alleviate painful symptoms, preserve the femoral head’s shape, and restore hip movement.
The pediatric orthopedic specialist will consider the following factors when formulating a treatment plan for a child,
Young children (2 to 6 years old) with some changes in the femoral head on their initial x-rays are kept on observation. The pediatric orthopedic specialist will use x-rays to regularly examine the child. It will ensure that the bone regrowth is progressing smoothly.
Inflammation of the hip joint causes painful symptoms. Anti-inflammatory medications, such as ibuprofen, are used to relieve pain and can be prescribed by the pediatric orthopedic specialist for some time. The pediatric orthopedic specialist will change the dose or stop the medication as the child progresses through the stages of the disease.
Running and jumping are high-impact movements that should be avoided to alleviate pain and protect the femoral head. To prevent the child from placing too much weight on the joint, the pediatric orthopedic specialist may recommend a walker or crutches.
In children with Perthes disease, hip stiffness is common. Physical therapy exercises are recommended to help restore the range of motion of the child’s hip joint. These exercises usually focus on hip abduction and internal rotation.
A pediatric orthopedic specialist may recommend surgery to re-align the bones of the hip and hold the femur head deep inside the acetabulum until the healing process is complete. Surgery is recommended when:
An osteotomy is the most common surgical technique used to treat Perthes disease. Under this procedure, the bone is cut and repositioned to hold the femoral head inside the acetabulum. This alignment is held with screws and plates, which will be removed after the healed stage of the disease.
In most cases, children with Perthes have a good long-term prognosis and grow without further hip problems.
If there is a remaining deformity in the shape of the femoral head, there is a higher risk of possible complications in the future. Hip pain or arthritis in adulthood will develop when the deformed femoral head does not fit well into the acetabulum.