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The Legg-Calve-Perthes Center is part of the Division of Orthopaedic Surgery at Cincinnati Children’s Hospital Medical Center. Legg-Calve-Perthes (LCP) disease is the most common hip disease that afflicts school-age children. It typically occurs at 4 to 8 years of age, with males being affected about four to five times more frequently than females. In nearly 90 percent of patients, the disease affects only one hip; the other 10 percent of patients have both hips affected.
The cause for LCP is unknown. We do know that the blood flow to the ball of the hip is insufficient. It is thought that an abnormality of either the arterial or the venous blood flow, or perhaps both, causes an interruption in the supply to the femoral head.
Researchers have identified thrombotic disorders in association with Legg-Calve-Perthes disease. Coagulation abnormalities are thought to lead to venous thrombosis within the femoral head and subsequent avascular necrosis.
Tobacco smoke appears to be another significant risk factor. Secondhand smoke carries a five times higher risk to those exposed to smoke vs. children who are not exposed.
The course of treatment must be determined for each child, but general treatment principles do exist. The primary goal is to prevent deformity by assuring containment of the femoral head (keeping the ball in the socket) and maintaining satisfactory range of motion of the hip joint.
Operative and nonoperative options are available for children depending on their age and the severity of the disease.
Nonoperative treatments include activity restriction, rest and nonweight-bearing methods, such as wheelchairs, crutches or Petrie casting. Operative treatments may include procedures such as medial release, greater trochanteric apophysiodesis, varus osteotomy, Salter pelvic osteotomy and lateral shelf arthroplasty. All of these treatment methods are aimed at improving containment and range of motion of the hip joint.
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Learn the ABCs of LCP. Download a glossary of terms you may hear during your child's evaluation and treatment.
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