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Heather L Baltzer, Scott Riester, Steven L Moran
Background: The etiology of multifocal osteonecrosis is not definitively known; however, hypercoagulable state is a very plausible cause. Methods: We present an unusual case of a 12-year-old boy with a history of Legg-Calve-Perthes disease presenting with right wrist pain who was subsequently diagnosed with Kienbock's disease. The finding of multifocal osteonecrosis prompted testing for a hypercoagulable state that was positive for Factor V Leiden thrombophilia. A thorough literature review using Medline database was conducted to investigate associations between inherited hypercoagulable states and multifocal osteonecrosis...
September 2016: Hand: Official Journal of the American Association for Hand Surgery
Naga Suresh Adapala, Ryosuke Yamaguchi, Matthew Phipps, Olumide Aruwajoye, Harry K W Kim
In children with Legg-Calvé-Perthes disease, loss of blood supply to the femoral head results in ischemic osteonecrosis. Generally, macrophages play important roles in the inflammatory response to tissue necrosis, but their role in ischemic osteonecrosis of the femoral head (ONFH) is not known. The purpose of this study was to determine the macrophage-inflammatory responses after ONFH and the receptor mechanisms involved in sensing the necrotic bone, using a piglet model of Legg-Calvé-Perthes disease. Induction of ONFH resulted in increased numbers of CD14(+) macrophages (4...
September 17, 2016: American Journal of Pathology
Eduardo N Novais, Stephen Duncan, Jeffrey Nepple, Gail Pashos, Perry L Schoenecker, John C Clohisy
BACKGROUND: The goal of periacetabular osteotomy (PAO) is to improve the insufficient coverage of the femoral head and achieve joint stability without creating secondary femoroacetabular impingement. However, the complex tridimensional morphology of the dysplastic acetabulum presents a challenge to restoration of normal radiographic parameters. Accurate acetabular correction is important to achieve long-term function and pain improvement. There are limited data about the proportion of patients who have normal radiographic parameters restored after PAO and the factors associated with under- and overcorrection...
September 19, 2016: Clinical Orthopaedics and related Research
C Druschel, K Heck, C Kraft, R Placzek
OBJECTIVE: PemberSal osteotomy to improve femoral head coverage by rotating the acetabular roof ventrally and laterally. INDICATIONS: Insufficient coverage of the femoral head, and can be combined with other surgical procedures such as femoral intertrochanteric varus-derotation osteotomy and open reduction for developmental dysplasia and dislocation of the hip or to improve sphericity and containment in Legg-Calvé-Perthes disease. This specific acetabuloplasty can only be performed in patients with an open epiphyseal growth-plate...
September 14, 2016: Operative Orthopädie und Traumatologie
Markus S Hanke, Simon D Steppacher, Helen Anwander, Stefan Werlen, Klaus A Siebenrock, Moritz Tannast
BACKGROUND: Magnetic resonance arthrogram (MRA) with radial cuts is presently the best available preoperative imaging study to evaluate chondrolabral lesions in the setting of femoroacetabular impingement (FAI). Existing followup studies for surgical treatment of FAI have evaluated predictors of treatment failure based on preoperative clinical examination, intraoperative findings, and conventional radiography. However, to our knowledge, no study has examined whether any preoperative findings on MRA images might be associated with failure of surgical treatment of FAI in the long term...
August 31, 2016: Clinical Orthopaedics and related Research
Soong Joon Lee, Jeong Joon Yoo, Hee Joong Kim
BACKGROUND: Total hip arthroplasty (THA) for sequelae of Legg-Calve-Perthes disease (LCPD) involves specific concerns for deformity, leg length discrepancy (LLD), and relatively young age. Excellent long-term outcome has been proven after Alumina-Alumina (Al-Al) THA for relatively young patients, however, there was no study for Al-Al THA for LCPD sequelae. The aim of this study is to evaluate the results of Al-Al THA for LCPD sequelae and to compare the results with those for adult-onset ONFH, in which THA is necessitated in relatively young age and excellent long term outcome has been proven after Al-Al THA...
August 10, 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
K Yao, J M Troupis
Diffusion-weighted imaging (DWI) is a magnetic resonance imaging (MRI) sequence that has a well-established role in neuroimaging, and is increasingly being utilised in other clinical contexts, including the assessment of various skeletal disorders. It utilises the variability of Brownian motion of water molecules; the differing patterns of water molecular diffusion in various biological tissues help determine the contrast obtained in DWI. Although early research on the clinical role of DWI focused mainly on the field of neuroimaging, there are now more studies demonstrating the promising role DWI has in the diagnosis and monitoring of various osseous diseases...
November 2016: Clinical Radiology
Talal Ibrahim, David G Little
No abstract text is available yet for this article.
July 19, 2016: JBJS Rev
Noam Shohat, Leonel Copeliovitch, Yossi Smorgick, Ran Atzmon, Yigal Mirovsky, Nogah Shabshin, Yiftah Beer, Gabriel Agar
BACKGROUND: Varus derotational osteotomy (VDRO) is one of the most common surgical treatments for Legg-Calvé-Perthes disease, yet its long-term results have not been fully assessed. We aimed to determine the long-term clinical and radiographic outcomes following VDRO. METHODS: Forty patients (43 hips) who underwent VDRO for Legg-Calvé-Perthes disease at our institution from 1959 to 1983, and participated in a follow-up study completed 10 years earlier, were approached for the present study...
August 3, 2016: Journal of Bone and Joint Surgery. American Volume
Tadahiko Ohtsuru, Yasuaki Murata, Yuji Morita, Yutaro Munakata, Yoshiharu Kato
Transient synovitis (TS) of the hip develops spontaneously in childhood; it usually has a good prognosis and is a self-limiting disease. However, its pathology is not well known. We describe a case of Legg-Calvé-Perthes disease (LCPD) that seemingly developed due to TS. Even if TS is diagnosed on the basis of the patient's medical history and imaging findings, physicians should consider the possibility of LCPD and perform a careful observation if joint effusion continues and/or a symptom does not improve within 4 weeks...
2016: Case Reports in Orthopedics
David Charles Neal, Travis Hall Alford, Amanda Moualeu, Chan-Hee Jo, John Anthony Herring, Harry K W Kim
INTRODUCTION: Children with Legg-Calvé-Perthes disease classically have been described as thin, small, and socioeconomically disadvantaged. Despite the obesity epidemic, no study has determined the prevalence of obesity in this patient population and its effect on treatment. METHODS: This is a retrospective study of 150 patients (172 hips) with Legg-Calvé-Perthes disease seen between 2009 and 2014. Patients were grouped based on body mass index at the initial visit...
September 2016: Journal of the American Academy of Orthopaedic Surgeons
Makoto Kamegaya, Mitsuaki Morita, Takashi Saisu, Jun Kakizaki, Yasuhiro Oikawa, Yuko Segawa
BACKGROUND: The concept of containment as an effective approach to reduce the risk of femoral head deformity has been questioned because modest results have been achieved after nonoperative and operative treatments for severely involved Legg-Calvé-Perthes disease. Several reports have shown the limited effectiveness of some conventional single procedures. However, there is limited data on the effectiveness of combined procedures. METHODS: The surgical group comprised 77 patients (mean age 8...
July 20, 2016: Journal of Pediatric Orthopedics
A R Zahedi, C Lüring, D Janßen
BACKGROUND: The Tönnis and Kalchschmidt triple pelvic osteotomy (TPO) has been performed at the Klinikum Dortmund for more than 30 years. In more than 5000 cases the TPO has proven its potential to deal with even severe dysplastic hips. TPO can be easily combined with other hip procedures as intertrochanteric osteotomies and even impingement treatment can easily be done. As an elaborate technique TPO respects the growth plates and can therefore also be used for treating Legg-Calve-Perthes disease...
August 2016: Der Orthopäde
Conor J Mullan, Lara J Thompson, Aidan P Cosgrove
BACKGROUND: Legg-Calve-Perthes' disease (LCPD) is an idiopathic disease of the femoral head affecting the pediatric population. The causative factors remains poorly understood and it is associated with significant hip pathology in adult life. Research has demonstrated wide geographical variation in the incidence rates of LCPD with a relatively high incidence occurring in Northern Ireland (NI) shown in a previous study of incidence from the same unit. The number of new diagnoses of LCPD seems to be declining over time...
June 18, 2016: Journal of Pediatric Orthopedics
Carlos Augusto Malheiros Luzo, Roberto Guarniero, Nei Botter Montenegro, Rui Maciel de Godoy Junior
OBJECTIVE: To present the preliminary results from treating patients with Legg-Calvé-Perthes Disease (LCPD) by means of hip arthrodiastasis using a monolateral external fixator applied to the hip and to succinctly describe the surgical technique used, in a prospective study. METHODS: Prospective study on 18 patients with LCPD who underwent surgical treatment by means of the hip arthrodiastasis technique using a monolateral external fixator. There were 13 male and five female patients of mean age 8...
May 2016: Revista Brasileira de Ortopedia
Felix Stief, André Schmidt, Stefanie Adolf, Laura Kremer, Moamer Brkic, Andrea Meurer
Current surgery outcome evaluations in patients with Legg-Calvé-Perthes disease (LCPD) are usually based on static radiological changes. The aim of the present study was to assess the development of characteristic gait parameters and passive hip range of motion (ROM) measurements during the postoperative period up to healed stage of the femoral head represented by Stulberg classification. Twelve children (10 male, 2 female) with unilateral diagnosis of LCPD and 19 healthy control subjects at the same age participated in this prospective longitudinal study...
June 2016: Gait & Posture
I Aguado-Maestro, J C Abril, A Bañuelos Diaz, M García Alonso
INTRODUCTION AND OBJECTIVE: Arthrodiastasis consists of the mobilisation of the hip while distracted by a hinged distractor. The aim of our study is to show the results of the treatment of late-onset Perthes disease with this technique in our institution. MATERIAL AND METHODS: Ambispective review of all the cases that underwent this surgery in our Department of Paediatric Orthopaedics between 2010 and 2014 with the following inclusion criteria: patients over 8 years old, with minimal deformity, and poor prognosis...
July 2016: Revista Española de Cirugía Ortopédica y Traumatología
Burak Kaymaz, Kadir Büyükdogan, Nazan Kaymaz, Erkam Kömürcü, Umut Hatay Golge, Ferdi Goksel, Mehmet Cemalettin Aksoy
BACKGROUND: Legg-Calvé-Perthes disease (LCPD) is the idiopathic avascular necrosis of the femoral head in childhood. The pathologic changes seen in the femoral head are likely a result of vascular factors. Blood neutrophil to lymphocyte (N/L) ratio is a simple marker of subclinical inflammation. This study aims to to analyse the predictive ability of N/L ratio for the prognosis in LCPD patients. METHODS: Patients who had been diagnosed as LCPD from 2008 to 2014 were investigated retrospectively and 40 LCPD patients (33 male and 7 female) and 25 healthy age and sex-matched children (controls) were included in the study...
May 23, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
André Cicone Liggieri, Marcos Josei Tamanaha, José Jorge Kitagaki Abechain, Tiago Moreno Ikeda, Eiffel Tsuyoshi Dobashi
OBJECTIVE: The aim of this study was to determine the intra and interobserver concordance rates of the Waldenström, Catterall and Herring classifications for Legg-Calvé-Perthes disease. METHODS: One hundred radiographs of the pelvis in anteroposterior and Lauenstein views, from patients with this disease, were selected. The radiographs were classified by four physicians with different levels of experience who had previously been given guidance regarding the classifications used, in order to minimize any bias of interpretation...
November 2015: Revista Brasileira de Ortopedia
Kamran Khan
No abstract text is available yet for this article.
2016: Pan African Medical Journal
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