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The team of experts in the Legg-Calve-Perthes Center at Cincinnati Children's provides answers to some of the most frequently asked questions.
The most complete name is Legg-Calve-Perthes disease (which gives credit to all three authors who discovered the disease in 1910). It is sometimes referred to as L-C-P, or as Legg-Perthes disease, or simply as Perthes disease. All of these names refer to the same thing: idiopathic avascular necrosis of the femoral head in children. It is the most common hip disease that afflicts school-age children.
No, LCP disease is not thought to be hereditary. There is no need to worry about other children in the family, nor their children. However, now that we are beginning to look into associated thrombotic disorders, there could be some correlation with individuals in the same family having the thrombotic disorder.
The diagnosis of Legg-Calve-Perthes disease is determined by the physical exam along with X-ray findings. The images will allow one to estimate what percentage of the femoral head is involved as well as help determine which Waldenström stage is present (initial, fragmentation, healing, growing). It can take four to six years for a patient to progress from the initial stage to the healing stage.
Once the diagnosis is made, several visits may be necessary for the orthopaedic surgeon to properly classify the disease using one of several classification systems aimed at placing patients into either a lower or a higher risk group. The more head involvement, the more concern one has for the future of the femoral head.
Children should participate in sports and activities only when there is no evidence of pain or limp. No jumping, hopping or bouncing activities are recommended. Football is not recommended; however, soccer, baseball and basketball may be played if no pain or limp is present.
The main prognostic factors are the patient’s age at onset, degree of limitation of range of motion and extent of involvement of the femoral head. Children diagnosed with Legg-Calve-Perthes disease while young often have the best outcome. Prognosis before the age of 6 is favorable, with 80 percent having a positive outcome. Most children with Legg-Calve-Perthes disease do well, and long-term studies show good outcomes for most. However, there are associated risks for the affected hip, such as associated pain, arthritis or further hip dysfunction.
Patients will be followed throughout the entire course of the disease on a regular basis. Follow-up will continue into adulthood to ensure proper care for the patient. Further assessment of the patient’s hip and the disease process will be noted at follow-up visits.
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