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Войти в исследования Frontiers in pediatrics · 2026
Long-term radiographic outcomes following containment surgery for Legg-Calvé-Perthes disease in the reossification stage.
СтатьяНазвание и аннотация: Перевод в очереди
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Zhang Huadong, Li Boxiang, Fu Zhe, Yang Jianping, Hu Jianwei, Liao Shijie, Zhang Zhongli
Аннотация
BACKGROUND: This study aimed to evaluate the long-term radiographic outcomes of containment surgery in children with Legg-Calvé-Perthes disease (LCPD) during the reossification stage.
METHODS: This retrospective study included 58 children diagnosed with Waldenström stage III LCPD. Patients were divided into a non-surgical group (n = 23, mean age 8.56 ± 1.74 years) and a surgical group (n = 35, mean age 8.28 ± 1.29 years). All patients were monitored with serial anteroposterior pelvic and frog-leg lateral radiographs. At the final follow-up, femoral head morphology was assessed using the modified Stulberg classification, while acetabular development was evaluated using the modified Tönnis angle and the acetabular head index (AHI).
RESULTS: All 58 patients were followed until skeletal maturity. The mean follow-up duration was 7.15 ± 2.68 years in the non-surgical group and 11.94 ± 5.31 years in the surgical group. At final follow-up, in the surgical group (n = 35), the simplified three-group modified Stulberg classification showed 34.3% Class I (Excellent; Stulberg I-II), 51.4% Class II (Good; Stulberg III), and 14.3% Class III (Poor; Stulberg IV-V). In the non-surgical group (n = 23), the corresponding proportions were 17.4%, 43.5%, and 39.1%, respectively. Although a trend toward more favorable outcomes was observed in the surgical group, the difference in the proportion of acceptable outcomes did not reach statistically significant (P = 0.057, OR = 3.857). However, the surgical group exhibited a significantly smaller modified Tönnis angle (6.12° ± 6.27° vs. 11.63° ± 5.73°, P = 0.002) and a higher AHI (86.98% ± 8.99% vs. 75.51% ± 6.70%, P < 0.001), indicating superior acetabular morphology and coverage.
CONCLUSION: Containment surgery performed during the reossification stage of LCPD was associated with significantly better acetabular morphology and coverage and showed a trend toward improved femoral head sphericity. These findings suggest that surgical intervention may be beneficial in select patients with LCPD during this stage of the disease.
METHODS: This retrospective study included 58 children diagnosed with Waldenström stage III LCPD. Patients were divided into a non-surgical group (n = 23, mean age 8.56 ± 1.74 years) and a surgical group (n = 35, mean age 8.28 ± 1.29 years). All patients were monitored with serial anteroposterior pelvic and frog-leg lateral radiographs. At the final follow-up, femoral head morphology was assessed using the modified Stulberg classification, while acetabular development was evaluated using the modified Tönnis angle and the acetabular head index (AHI).
RESULTS: All 58 patients were followed until skeletal maturity. The mean follow-up duration was 7.15 ± 2.68 years in the non-surgical group and 11.94 ± 5.31 years in the surgical group. At final follow-up, in the surgical group (n = 35), the simplified three-group modified Stulberg classification showed 34.3% Class I (Excellent; Stulberg I-II), 51.4% Class II (Good; Stulberg III), and 14.3% Class III (Poor; Stulberg IV-V). In the non-surgical group (n = 23), the corresponding proportions were 17.4%, 43.5%, and 39.1%, respectively. Although a trend toward more favorable outcomes was observed in the surgical group, the difference in the proportion of acceptable outcomes did not reach statistically significant (P = 0.057, OR = 3.857). However, the surgical group exhibited a significantly smaller modified Tönnis angle (6.12° ± 6.27° vs. 11.63° ± 5.73°, P = 0.002) and a higher AHI (86.98% ± 8.99% vs. 75.51% ± 6.70%, P < 0.001), indicating superior acetabular morphology and coverage.
CONCLUSION: Containment surgery performed during the reossification stage of LCPD was associated with significantly better acetabular morphology and coverage and showed a trend toward improved femoral head sphericity. These findings suggest that surgical intervention may be beneficial in select patients with LCPD during this stage of the disease.