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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.
Mehlman CT, McCourt JB. Legg-Calve-Perthes Disease: Where Are We 100 Years Later? The Orthopod, Fall 2010.
Glueck CJ, Tracy T, Wang P. Legg-Calve-Perthes Disease, Venous and Arterial Thrombi and the Factor V Leiden Mutation in a Four-Generation Kindred. J Pediatr Orthop 2007;27:834-837.
Balasa VV, Gruppo RA, Glueck CJ, Wang P, Roy DR, Wall EJ, Mehlman CT, Crawford AH. Legg-Calve-Perthes Disease and Thrombophilia. J Bone Joint Surg Am. 2004;86:2642-2647.
Kuwajima SS, Crawford AH, Ishida A, Roy DR, Laredo Filho J, Milani C. Comparison Between Salter’s Innominate Osteotomy and Augmented Acetabuloplasty in the Treatment of Patients with Severe Legg-Calve-Perthes Disease. Analysis of 90 Hips with Special Reference to Roentgenographic Sphericity and Coverage of the Femoral Head. J Pediatr Orthop Part B, Vol. 11, No. 1, 2002.
Gruppo R, Glueck CJ, Wall E, Roy D, Wang P. Legg-Perthes disease in three siblings, two heterozygous and one homozygous for the factor V Leiden mutation. J Pediatr, 1998.
Glueck CJ, Crawford A, Roy D, Freiberg R, Glueck H, Stroop D. Association of Antithrombotic Factor Deficiencies and Hypofibrinolysis with Legg-Perthes Disease. J Bone Joint Surg Am. 1996;79:3-13.
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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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