TO EXAMINE THE POTENTIAL ROLE OF CENTRAL BONE GRAFTING AS A METHOD OF PREVENTING FEMORAL HEAD COLLAPSE IN AN ANIMAL MODEL OF LEGG CALVE PERTHES DISEASE.

Abstract

First described in 1910, Legg Calve Perthes disease is considered to be a complication of osteonecrosis of the femoral head-affecting children between the ages of 2 and 12. Treatment has centred on containment, surgical and non-surgical in the hope that keeping the femoral head covered by acetabulum that it will remodel and maintain congruency with the acetabulum. We know from previous studies that deformities of the femoral head increase the risk of development of arthritis in later life and that the shape of the femoral head is the only alterable parameter in the development of this early onset arthritis.

During the natural history of the disease, once the central part of the femoral head collapses the integrity of the femoral head is reliant on the support of the lateral and medial columns. These columns then collapse altering the shape of the femoral head. We induced LCPD in the femoral heads of twenty skeletally immature rabbits and buttressed the central column of the femoral head in twelve. These treated rabbits had cement, bone graft or bone paste inserted through a drill hole that extended into the centre of the femoral head. The rabbits were then recovered and x-rayed at six weeks. All the rabbits had evidence of varying degrees of head collapse radiologically. Once the rabbits reach skeletal maturity in March, they will be euthanised and their femoral heads examined histologically and radiologically to determine the effects of central column enhancement by each of the three substances.