Tan Jonathan, Sharma Anirudh, Bansal Rohit, Tan Qier, Prior Heather J, McRae Sheila, McCammon James R
Division of Orthopaedic Surgery, University of Manitoba, Winnipeg, MB R3A 1R9, Canada.
School of Medicine, University of California San Francisco, Fresno, CA 93701, USA.
Pediatr Rep. 2023 Oct 7;15(4):582-590. doi: 10.3390/pediatric15040053.
Legg Calve Perthes disease is a pediatric hip condition that leads to early hip degeneration. The efficacy of operative and nonoperative treatment is not well defined in the literature. Using the rate of total hip arthroplasty as a surrogate measure for symptomatic hip degeneration, the rate of total hip arthroplasty was compared in Legg Calve Perthes disease patients with and without previous surgical intervention in the province of Manitoba, Canada. A retrospective review was conducted using de-identified, individual-level administrative records of health services for the entire population of Manitoba. Codes for Legg Calve Perthes disease, femoral osteotomies, pelvic osteotomies, adductor tenotomies, and total hip arthroplasty were searched from 1984 to 2018. The rate of total hip arthroplasty in patients with Legg Calve Perthes disease was determined for two groups: (1) patients with earlier surgical intervention and (2) patients with no previous surgical intervention. Of the 202 patients included in the study, 180 had no prior surgery and 22 had prior surgery. The rate of total hip arthroplasty between the previous operative and nonoperative groups was found to be 32% and 40%, respectively ( = 0.458). There was no significant difference in rates of total hip arthroplasty in the operative and nonoperative groups. Further prospective studies are required to elucidate the differences in outcomes between operative and nonoperative treatment groups in patients with Legg Calve Perthes disease.
Legg-Calvé-Perthes病是一种导致早期髋关节退变的儿科髋关节疾病。手术治疗和非手术治疗的疗效在文献中尚无明确界定。以全髋关节置换率作为有症状髋关节退变的替代指标,对加拿大曼尼托巴省有或无既往手术干预的Legg-Calvé-Perthes病患者的全髋关节置换率进行了比较。利用曼尼托巴省全体人口去识别化的个人层面医疗服务行政记录进行了一项回顾性研究。检索了1984年至2018年期间Legg-Calvé-Perthes病、股骨截骨术、骨盆截骨术、内收肌切断术和全髋关节置换术的编码。确定了Legg-Calvé-Perthes病患者两组的全髋关节置换率:(1)早期接受手术干预的患者和(2)无既往手术干预的患者。在纳入研究的202例患者中,180例无既往手术史,22例有既往手术史。既往手术组和非手术组的全髋关节置换率分别为32%和40%(P = 0.458)。手术组和非手术组的全髋关节置换率无显著差异。需要进一步开展前瞻性研究以阐明Legg-Calvé-Perthes病患者手术治疗组和非手术治疗组之间的疗效差异。