Abstract
Purpose
Surgical dislocation is useful for assessing and treating proximal femoral hip deformities. Legg-Calv Perthes disease (LCPD) causes proximal femoral growth deformity, resulting in reduced femoral head-neck offset and femoracetabular incongruity. The purpose of this study was to demonstrate the efficacy and report the short-term results of surgical hip dislocation for the treatment of adolescents with healed LCPD.
Method
This retrospective review included 29 adolescents [19 males and 10 females, age 17 (range nine-35)] with LCPD, who underwent surgical hip dislocation between January 2001 and December 2009. All subjects had a clear diagnosis of LCPD, pre and postoperative WOMAC scores and at least one year of clinical and radiographic follow up. In addition to surgical dislocation, all patients underwent femoral head-neck osteoplasty, 21 underwent relative femoral neck lengthening and trochanteric transfer, 12 underwent intertrochanteric osteotomy and seven had labral debridement. The average follow-up was three years from the time of surgical intervention.
Results
Postoperative WOMAC scores improved globally for pain, stiffness and function (p<0.0001, p<0.0004 and p<0.0009 respectively). Eight patients required additional surgical procedures after surgical dislocation (one periacetabular osteotomy, one flexion intertrochanteric osteotomy, one arthrotomy, five arthroscopies with labral/cartilage debridement. Three patients underwent total hip arthroplasties during the follow-up period and were considered failures. Two of the 29 patients experienced superficial wound complications.
Conclusion
Surgical dislocation is an effective technique for the treatment of proximal femur deformity associated with LCPD. In the short-term, patients experience improved symptoms and function from this procedure.
