BookDavid S. Feldman, Dror Paley, editors.
Summary: Legg-Calvé-Perthes Disease (LCPD) remains a challenging hip condition to treat. More than a century after its identification, the etiology of LCPD remains unclear and treatment continues to be controversial. The main goal of treatment is to prevent femoral head deformation. Preservation of femoral head sphericity is known to minimize the risk of premature hip pain, stiffness and arthritis. The best ways to achieve these goals remain elusive. This book is replete with up-to-date discussions of history, epidemiology, radiology and classification systems for LCPD. It takes a well-balanced, evidence-based approach to various methods of treatment, from conventional containment femoral and pelvic surgery, to more cutting-edge procedures such as transfemoral head-neck tunneling, hip distraction, hip arthroscopy and intraarticular femoral head reshaping osteotomies, ending with a discussion of the latest biologic and pharmacologic treatment strategies. It is a well-illustrated tome for the various surgical techniques presented. The chapter authors, all experts in LCPD, share their practical, innovative and comprehensive approach to this challenging condition. Legg-Calvé-Perthes Disease will be the definitive reference work on this condition for many years to come.
Contents:
Intro
Preface
About the Editors
Contents
Contributors
1: History and Epidemiology of Legg-Calvé-Perthes Disease
Who is at Risk and How do We Diagnose it?
History
Epidemiology
Risk Factors and Prediction
What Makes it Worse?
Symptoms and Clinical and Radiological Examination
References
2: Staging and Classification of Severity of Legg-Calvé-Perthes Disease and Its Relevance
Catterall Classification
Herring (Lateral Pillar) Classification
Salter-Thompson Classification
Stulberg Classification Waldenstrom and Modified Waldenstrom (Elizabethtown) Classification
Works Cited
3: Treatment of Legg-Calvé-Perthes Disease by Maintaining Abduction to Allow Dynamic Hip Modeling Through Range-of-Motion Therapy
Rationale
Indication
OR Technique
Abduction/Range-of-Motion Care
The Problematic Hip
Duration of Treatment
Response to and Outcome of Treating LCPD
Summary
References
4: Prevention and Early Treatment of Legg-Calvé-Perthes Disease Utilizing Transphyseal Neck-Head Tunnelling (TNHT)
Introduction
Pathogenesis of LCPD: An Experimental Animal Model Effect of Transphyseal Neck-Head Tunnelling
Experimental Animal Model
Surgical Technique of TNHT
Clinical Use of TNHT in Children with IDGH
Clinical Use of TNHT in Children with Early LCPD
Conclusions
Bibliography
5: Varus Derotational Osteotomy as Treatment of Legg-Calvé-Perthes Disease
Introduction
History
Biology
Techniques
Time of Intervention
Complications
Conclusions
References
6: Pelvic Osteotomies as Treatment for Legg-Calvé-Perthes Disease
Introduction
Innominate Osteotomy
Shelf/Chiari Pelvic Osteotomy Combined VDRO with Innominate Osteotomy
Triple Innominate Osteotomy
Conclusion
References
7: Treatment of Legg-Calvé-Perthes Disease of the Hip by Joint Distraction
Introduction
Surgical Procedure (Fig. 7.1 and 7.2)
Postoperative Management of Distraction Treatment for Perthes Disease
Results
Complications
Discussion
References
8: Comparison Between Distraction and Femoral Varus Osteotomy in the Treatment of Legg-Calvé-Perthes Disease
Introduction
Femoral Varus Osteotomy
Indication
Surgical Technique Considerations Advantages of Femoral Varus Osteotomy
Disadvantages of Femoral Varus Osteotomy
Hip Distraction: Arthrodiastasis
Comparison Between Distraction and Femoral Varus Osteotomy
References
9: Femoral Head Reduction Osteotomy for Coxa Magna and Nonspherical Femoral Head for Legg-Calvé-Perthes Disease
Goals of Treatment
Treatment Strategy
Surgical Details of Femoral Head Reduction Osteotomy
Postoperative Care
Postoperative Considerations
Case Examples
Pearls and Pitfalls
Outcome of Ganz- and Paley-Type FHRO
Summary
References