Dergiler / Acta Orthopaedica et Traumatologica Turcica / 2022 / Cilt: 56 - Sayı: 3

Radiographical and clinical results of a new conservative treatment algorithm in Legg-Calvè-Perthes disease: A retrospective study

Sayfa
187–193
Yayın Tarihi
2022-10-10
DOI
—
🏛️Bu makalenin bibliyografik verileri ve tam metin bağlantısı DergiPark üzerinden sağlanmıştır.
DergiPark Kaydı ↗
✨

Yapay Zeka Hızlı Bakış & Çıkarımlar

AI Insight
⚡ TL;DR(1 Cümlede Hızlı Çıkarım)

Although lateral pillar classification was efficient to predict radiographic results, the Stulberg classification was not correlated with the clinical results for every subgroup.

📌 3 Maddede Bu Makale

🎯
Amaç & Hipotez:Objective: This study aimed to establish a feasible conservative treatment algorithm for Legg-Calvè-Perthes Disease (LCPD), clarify its limitations, and evaluate the correlations between radiographical and clinical results.
📊
Temel Bulgular & Veri:Methods: Patients diagnosed with LCPD and treated conservatively were evaluated retrospectively; 39 hips from 35 patients were included.
💡
Sonuç & Katkı:Although lateral pillar classification was efficient to predict radiographic results, the Stulberg classification was not correlated with the clinical results for every subgroup.
🔬Tür:Araştırma Makalesi
📍Kapsam:Genişletilmiş Akademik Örneklem
⚙️Değişkenler:Alan Parametreleri

Abstract

Objective: This study aimed to establish a feasible conservative treatment algorithm for Legg-Calvè-Perthes Disease (LCPD), clarify its limitations, and evaluate the correlations between radiographical and clinical results. Methods: Patients diagnosed with LCPD and treated conservatively were evaluated retrospectively; 39 hips from 35 patients were included. The treatment protocol consisted of intermittent manual traction, range of motion exercises, activity limitation, bed rest, NSAID (ibuprofen 100mg/5mL), and ASA (100mg/day) during attack periods. The treatment protocol was standardized, and an algorithm was established for all the patients. Results: The mean follow-up was 13.7 (range = 8-22) years. According to the Stulberg classification, 26 (67%) hips were good, 6 (15,3%) were fair, and 7 (17%) were poor. No activity-limiting pain was detected in any patient. The mean Harris score was 90.5 ± 5.3 for Stulberg type 1, 2, and 3 hips, but 84.2 ± 8.8 for Stulberg type 4 and 5 hips. When the patients were evaluated in terms of pain, activity, and function, it was seen that pain and activity were not different, especially in the Stulberg 1, 2, 3, and 4 patients during the mid-term follow-up. The function was the main factor correlating with the Stulberg classification. Twenty-nine (82.8%) families defined the applicability of the treatment protocol as “easy,” 4 (10.3%) defined it as “moderate,” and 2 (6.2%) defined it as “difficult.” Conclusion: The present study demonstrated that the treatment protocol was successful and easily applicable to LCPD. Although lateral pillar classification was efficient to predict radiographic results, the Stulberg classification was not correlated with the clinical results for every subgroup.

🔖

Bu Makaleye Atıf Yap

ECEVİZ, E., SÖYLEMEZ, M. S., EREN, A., ESENKAYA, İ. (2022). Radiographical and clinical results of a new conservative treatment algorithm in Legg-Calvè-Perthes disease: A retrospective study. Acta Orthopaedica et Traumatologica Turcica, Cilt: 56 - Sayı: 3, 187–193. https://ajindex.com/articles/427953

📄 Tam Metin PDF Okuyucu

📄

PDF görüntüleyici hazırlanıyor...

Kaynakça (15)

  1. Price CT, Day DD, Flynn JC. Behavioral sequelae of bracing versus surgery or Legg-Calvé-Perthes’ disease. J Pediatr Orthop. 1988
  2. 8(3):285-287. [CrossRef] 2. Weinstein SL. Legg Calve Perthes syndrome. In: Weinstein SL, ed. Lovell & Winter’s Pediatric Orthopaedics. Philadelphia: Lippincott, Williams & Wilkins
  3. 1045, 1061-1064, 1070-1074. 3. Herring JA, Kim HT, Browne R. Legg-Calve-Perthes disease. Part II: Prospective multicenter study of the effect of treatment on outcome. J Bone Joint Surg Am. 2004
  4. 86(10):2121-2134. [CrossRef] 4. Herring JA, Williams JJ, Neustadt JN, Early JS. Evolution of femoral head deformity during the healing phase of Legg-Calve-Perthes disease. J Pediatr Orthop. 1993
  5. 13(1):41-45. [CrossRef] 5. Rab GT, DeNatale JS, Herrmann LR. Three-dimensional finite element analysis of Legg-Calve-Perthes disease. J Pediatr Orthop. 1982
  6. 2(1):39-44. [CrossRef] 6. Beaty JH. Congenital and developmental anomalies of hip and pelvis. In: Canale ST, Beaty JH, eds. Campbell’s Operative Orthopaedics. 11th ed
  7. Philadelphia: Mosby/Elsevier
  8. Prather H, Harris-Hayes M, Hunt DM, Steger-May K, Mathew V, Clohisy JC. Reliability and agreement of hip range of motion and provocative physical examination tests in asymptomatic volunteers. PM R. 2010
  9. 2(10):888-895. [CrossRef] 8. Herring JA, Kim HT, Browne R. Legg-Calve-Perthes disease. Part I. Classification of radiographs with use of the modified LP and Stulberg classifications. J Bone Jt Surg Am. 2004
  10. 86(10):2103-2120. 9. Stulberg SD, Cooperman DR, Wallensten R. The natural history of Legg-Calvé- Perthes disease. J Bone Joint Surg Am. 1981
  11. 63(7):1095-1108. [CrossRef] 10. Catterall A. The natural history of Perthes' disease. J Bone Joint Surg Br. 1971
  12. 53(1):37-53. 11. Hsu JE, Baldwin KD, Tannast M, Hosalkar H. What is the evidence supporting the prevention of osteoarthritis and improved femoral coverage after shelf procedure for Legg-Calvé-Perthes disease? Clin Orthop Relat Res. 2012
  13. 470(9):2421-2430. [CrossRef] 12. Larson AN, Sucato DJ, Herring JA, et al. A prospective multicenter study of Legg-Calvé-Perthes disease: functional and radiographic outcomes of nonoperative treatment at a mean follow-up of twenty years. J Bone Joint Surg Am. 2012
  14. 94(7):584-592. [CrossRef] 13. Shah H. Perthes disease: evaluation and management. Orthop Clin North Am. 2014
  15. 45(1):87-97. [CrossRef] 14. Arkader A, Sankar WN, Amorim RM. Conservative versus surgical treatment of late-onset Legg-Calve-Perthes disease: a