Long-term results of proximal femoral osteotomy in legg-calvé- perthes disease

BACKGROUND: Legg-Calvé-Perthes disease is a childhood hip disorder that may result in a deformed and poorly functioning hip. The purpose of this study was to evaluate the correlation between hip deformity at skeletal maturity and degenerative osteoarthritis and to present the long-term results of proximal femoral varus derotational osteotomy in Legg-Calvé-Perthes disease. METHODS: We analyzed the results of 40 patients (43 hips), who underwent proximal femoral varus derotational osteotomy for Legg-Calvé- Perthes disease in our institution between 1959 and1983. All available patients underwent a single long-term follow-up examination. Hips were classified with the classification system of Stulberg. Osteoarthritis was evaluated using the Tönnis classification. The long-term outcomes were evaluated after a mean follow-up period of 33 years. RESULTS: When examining the outcome using the Stulberg classification system, there were 8 Stulberg class I hips (19.5%), 15 Stulberg class II hips (36.6%), 8 Stulberg class III hips (19.5%), 9 Stulberg class IV hips (22%), and 1 Stulberg class V hip (2.4%). One patient, who had a bilateral Legg-Calvé-Perthes disease, underwent total hip replacement for osteoarthritis. Seven patients had poor clinical results. CONCLUSIONS: Proximal femoral varus derotational osteotomy provides good long-term results for Legg-Calvé-Perthes disease. The Stulberg classification is a good predictor for patient outcome. LEVEL OF EVIDENCE: Level IV, therapeutic study.