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Perthes disease

Matthew R Schmitz, Todd J Blumberg, Susan E Nelson, Julieanne P Sees, Wudbhav N Sankar
BACKGROUND: Developmental dysplasia of the hip (DDH), which encompasses a wide spectrum of disease from mild dysplasia to frank dislocation, is one of the most common developmental deformities of the lower extremities and one of the leading causes of future osteoarthritis and hip arthroplasty. Legg-Calvé-Perthes disease (LCPD) results from a vascular insult to the growing femoral epiphysis, which in turn can create permanent morphologic changes to the hip joint. Slipped capital femoral epiphysis (SCFE) occurs when the proximal femoral physis fails allowing the epiphysis to displace in relation to the metaphysis...
March 17, 2018: Journal of Pediatric Orthopedics
Mejbah Uddin Bhuiyan, Thomas L Snelling, Rachel West, Jurissa Lang, Tasmina Rahman, Meredith L Borland, Ruth Thornton, Lea-Ann Kirkham, Chisha Sikazwe, Andrew C Martin, Peter C Richmond, David W Smith, Adam Jaffe, Christopher C Blyth
INTRODUCTION: Pneumonia is the leading cause of childhood morbidity and mortality globally. Introduction of the conjugate Haemophilus influenzae B and multivalent pneumococcal vaccines in developed countries including Australia has significantly reduced the overall burden of bacterial pneumonia. With the availability of molecular diagnostics, viruses are frequently detected in children with pneumonia either as primary pathogens or predispose to secondary bacterial infection. Many respiratory pathogens that are known to cause pneumonia are also identified in asymptomatic children, so the true contribution of these pathogens to childhood community-acquired pneumonia (CAP) remains unclear...
March 16, 2018: BMJ Open
Elizabeth Wilson, Peter Cox, Karen Greaves, Siba Prosad Paul
Children with acute onset non-traumatic limp often present to emergency departments (EDs). The limp can occasionally be associated with medical emergencies such as septic arthritis and slipped upper femoral epiphysis but is often due to less severe conditions. This article discusses the common and self-limiting causes of acute onset of non-traumatic limp in children, such as transient synovitis, reactive arthritis, and benign acute childhood myositis. It also discusses more severe conditions, including septic arthritis, osteomyelitis, slipped upper femoral epiphysis, Perthes disease, malignancies and non-accidental injury...
March 9, 2018: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
Yasmin D Hailer, Nils P Hailer
BACKGROUND: Osteochondrosis includes numerous diseases that occur during rapid growth, characterized by disturbances of endochondral ossification. One example, Legg-Calvé-Perthes disease, is characterized by disruption of the blood supply to the femoral head epiphysis, and a systemic etiology often has been suggested. If this were the case, secondary osteochondroses at locations other than the hip might be expected to be more common among patients with Legg-Calvé-Perthes disease, but to our knowledge, this has not been evaluated in a nationwide sample...
February 23, 2018: Clinical Orthopaedics and related Research
C Mallet, A Abitan, C Vidal, L Holvoet, K Mazda, A-L Simon, B Ilharreborde
Purpose: Sickle cell disease (SCD) is the most common cause of femoral head osteonecrosis (ONFH) during childhood with an overall prevalence of 10%. In children, spontaneous revascularization can occur, as in Legg-Calve-Perthes disease. Consequently, the aim of treatment is to restore proper hip containment to prevent joint arthritis. This is the first study reporting long-term results at skeletal maturity of non-operative and surgical treatments for ONFH in SCD children. Methods: All children with ONFH due to SCD were retrospectively reviewed...
February 1, 2018: Journal of Children's Orthopaedics
Christian Dippmann, Otto Kraemer, Bent Lund, Michael Krogsgaard, Per Hölmich, Martin Lind, Karen Briggs, Marc Philippon, Bjarne Mygind-Klavsen
INTRODUCTION: Hip arthroscopy has become a standard procedure in the treatment of hip joint pain not related to osteoarthritis or dysplasia in the young and active patient. There has been increasing focus on the contribution of the hip capsule to function and on stability following hip arthroscopy. It has been suggested that capsular closure after hip arthroscopy may prevent microinstability and macroinstability of the hip joint and reduce revision rate. However, it remains unknown whether capsular closure should be performed as a standard procedure when performing hip arthroscopies, especially in patients without additional risk factors for instability such as hypermobility or dysplasia of the hip...
February 10, 2018: BMJ Open
M Pinheiro, C A Dobson, D Perry, M J Fagan
OBJECTIVES: Legg-Calvé-Perthes' disease (LCP) is an idiopathic osteonecrosis of the femoral head that is most common in children between four and eight years old. The factors that lead to the onset of LCP are still unclear; however, it is believed that interruption of the blood supply to the developing epiphysis is an important factor in the development of the condition. METHODS: Finite element analysis modelling of the blood supply to the juvenile epiphysis was investigated to understand under which circumstances the blood vessels supplying the femoral epiphysis could become obstructed...
February 2018: Bone & Joint Research
Manuel da Silva Pinheiro, Catherine Dobson, Nicholas M Clarke, Michael Fagan
Legg-Calvé-Perthes disease (LCP) is one of the most poorly understood diseases in paediatric orthopaedics. One common trait of LCP is the marked morphological difference between healthy and pathological hips, early deviations of which (i.e. prior to disease onset) have been suggested to lead to the overload and collapse of the epiphysis. Here, the impact of common variations in geometry is investigated with a finite element model of a juvenile femur under single leg standing and landing. Here, the impact of typical variations in geometry is investigated with a finite element model of a juvenile femur under single leg standing and landing...
February 8, 2018: Computer Methods in Biomechanics and Biomedical Engineering
Junzhong Luo, Jiuhui Han, Yazhou Li, Yuchang Liu
Legg-Calvé-Perthes disease (LCPD) commonly onsets in adolescents, and threatens their health. However, the potential mechanism underlying LCPD remains unclear. MicroRNA (miR)-206 and SRY-box 9 (SOX9) serve an important role in chondrocytes; however, their role in LCPD remains ambiguous. In the present study, whether miR-206 and SOX9 mediated cell apoptosis in dexamethasone (DEX)-induced LCPD was investigated. The chondrocytes of the LCPD and normal control group were isolated from clinical tissues. Reverse transcription-quantitative polymerase chain reaction was used to evaluate the expression of miR-206 and SOX9 mRNA...
January 2018: Oncology Letters
Donatella Milani, Giulietta Scuvera, Marta Gatti, Gianluca Tolva, Francesca Bonarrigo, Susanna Esposito, Cristina Gervasini
Floating-Harbor Syndrome (FHS; OMIM #136140) is an ultra-rare autosomal dominant genetic condition characterized by expressive language delay, short stature with delayed bone mineralization, a triangular face with a prominent nose, and deep-set eyes, and hand anomalies. First reported in 1973, FHS is associated with mutations in the SRCAP gene, which encodes SNF2-related CREBBP activator protein. Mutations in the CREBBP gene cause Rubinstein-Taybi Syndrome (RSTS; OMIM #180849, #613684), another rare disease characterized by broad thumbs and halluces, facial dysmorphisms, short stature, and intellectual disability, which has a phenotypic overlap with FHS...
January 31, 2018: American Journal of Medical Genetics. Part A
M J Bertoldo, P H Andraweera, E G Bromfield, F L Cousins, L A Lindsay, P Paiva, S L Regan, R D Rose, L K Akison
Research in reproductive science is essential to promote new developments in reproductive health and medicine, agriculture and conservation. The Society for Reproductive Biology (SRB) 2017 conference held in Perth (WA, Australia) provided a valuable update on current research programs in Australia and New Zealand. This conference review delivers a dedicated summary of significant questions, emerging concepts and innovative technologies presented in the symposia. This research demonstrates significant advances in the identification of precursors for a healthy pregnancy, birth and child, and discusses how these factors can influence disease risk...
January 31, 2018: Reproduction, Fertility, and Development
Yen Ying Lim, Pawel Kalinowski, Robert H Pietrzak, Simon M Laws, Samantha C Burnham, David Ames, Victor L Villemagne, Christopher J Fowler, Stephanie R Rainey-Smith, Ralph N Martins, Christopher C Rowe, Colin L Masters, Paul T Maruff
Importance: Older age, high levels of β-amyloid (Aβ), and the presence of the apolipoprotein E (APOE) ε4 allele are risk factors for Alzheimer disease (AD). However, the extent to which increasing age, Aβ, and ε4 are associated with memory decline remains unclear, and the age at which memory decline begins for Aβ-positive ε4 carriers and noncarriers has not been determined. Objective: To determine the association of age, Aβ level, and APOE ε4 with memory decline in a large group of cognitively healthy older adults...
January 22, 2018: JAMA Neurology
Kathrin S Bieri, Kelly Goodwin, Emin Aghayev, Hans-Joachim Riesner, Ralph Greiner-Perth
PURPOSE:  The primary aim of dynamic stabilization is to stabilize the spine and preserve function without overstressing adjacent segments, which is a potential risk of fusion surgery. However, direct comparative analyses of the two approaches are still limited, and little is known about the association of patient-reported outcomes with these treatment options. OBJECTIVE:  To compare the clinical outcomes of dynamic posterior stabilization using the DSS Stabilization System (Paradigm Spine, LLC, New York, New York, United States) versus posterior lumbar intervertebral fusion (PLIF) based on data from a spine registry...
January 18, 2018: Journal of Neurological Surgery. Part A, Central European Neurosurgery
Sophie Merckaert, Pierre-Yves Zambelli
Perthes's disease corresponds to an interruption of the vascularization of the epiphyseal nucleus of the femoral head followed by avascular necrosis. This necrosis weakens the bone and subchondral fractures associated with a deformation of the femoral head is seen. It is important not to miss an extrusion of the femoral head, which makes surgical treatment unavoidable. The loss of joint congruence causes functional limitations and represents an increased risk for early hip osteoarthritis. Non weight bearing limits the subchondral fractures, but requires an important adaptation from the patient and his entourage...
January 10, 2018: Revue Médicale Suisse
Benjamin J Shore, Patricia E Miller, Ira Zaltz, Perry L Schoenecker, Wudbhav N Sankar
BACKGROUND: Although hinge abduction is recognized as an important finding in children with Legg-Calvé-Perthes disease, variable diagnostic criteria exist. The purpose of this study was (1) to test the interobserver and intraobserver agreement of the current definition of hinge abduction and (2) to develop consensus regarding key diagnostic features that could be used to improve our diagnostic criteria. METHODS: Four orthopaedic surgeons with subspecialty pediatric hip interest independently assessed 30 randomly ordered cases of Legg-Calvé-Perthes disease...
December 6, 2017: Journal of Pediatric Orthopedics
Kyung Soon Park, Kyu Jin Cho, Hong Yeol Yang, Kamolhuja Eshnazarovich Eshnazarov, Taek Rim Yoon
Background: In a previous study, we reported clinical and radiographic results of our modified Salter innominate osteotomy technique in 16 hips affected by Legg-Calvé-Perthes disease (LCPD) with an average follow-up of 31.8 months. In this study, we present the long-term results of the osteotomy in LCPD patients followed until physeal closure. Methods: Thirty hips of 29 patients were followed until skeletal maturation after modified Salter innominate osteotomy...
December 2017: Clinics in Orthopedic Surgery
David E Hartigan, Itay Perets, Edwin O Chaharbakhshi, John P Walsh, Leslie C Yuen, Benjamin G Domb
This study compared patients who underwent femoral head microfracture with a control group of patients who did not require microfracture. Patients had more than 2 years of follow-up. The patient groups had similar demographic and radiographic features, including sex, age within 5 years, body mass index within 5 points, equal Tönnis grade, lateral center edge angle within 5°, labral treatment, and capsular closure vs release. Inclusion criteria were a minimum of 2 years of follow-up, Outerbridge grade IV cartilage damage, and femoral head marrow stimulation technique performed at the time of arthroscopy...
January 1, 2018: Orthopedics
Woo-Yong Lee, Deuk-Soo Hwang, Yong-Chan Ha, Pil-Sung Kim, Long Zheng
INTRODUCTION: The residual hip deformities after Legg-Calvé-Perthes disease (LCPD) cause mechanical symptoms and are associated with a pathomechanical environment that can feature femoroacetabular impingement (FAI).The aim of this study is to evaluate the clinical and radiological outcomes in residual or healed LCPD after arthroscopic treatment. PATIENTS AND METHODS: We retrospectively reviewed patients with LCPD amongst patients with FAI who underwent arthroscopic treatment between January 2009 and June 2013...
December 1, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
M A Eid
BACKGROUND: Impingement ensures a narrow arc of pathologic loading in adolescent hips with sequelae of Perthes Disease. Proper surgical interference when the hip is still in the pre-arthritic stage restores function and protects the young hip from early degenerative changes. METHODS: Osteochondroplasty at the femoral head-neck junction and relative lengthening of the femoral neck by distal transfer of the greater trochanter was performed for 12 adolescents with combined intra-articular/extra-articular impingement due to sequelae of Perthes disease in terms of coxa magna, coxa plana, coxa brevis, with an overriding greater trochanter...
December 2016: Acta Orthopaedica Belgica
Ashishkumar K Parikh, Eleby R Washington, Adam J Bobbey, Stephanie E Spottswood
BACKGROUND: Evaluating postoperative patients with hardware is challenging following surgical intervention for hip maladies such as femoral neck fractures and slipped capital femoral epiphysis (SCFE). These children are at increased risk of developing avascular necrosis, and imaging may be requested to confirm or exclude this diagnosis. Children with Legg-Calvé-Perthes disease can be monitored for restoration of blood flow to the capital femoral epiphysis to guide management and help with prognosis...
March 2018: Pediatric Radiology
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