Long-term clinical and radiological outcomes after valgus extension osteotomy and tectoplasty for advanced Legg-Calve-Perthes disease.

OBJECTIVE

We evaluated the long-term clinical and radiographic outcomes of femoral valgus extension osteotomy combined tectoplasty in Herring group C Perthes disease patients with hinge abduction.

METHOD: A total of 13 patients underwent this procedure between 2002 and 2009. In this retrospective study, all patients were classified as Herring group C. The mean age at diagnosis was 8.6 ± 2.2 years. The mean age at surgery was 9.3 ± 1.7 years. The mean age at the most recent follow-up was 23.3 years (range 19-29 years). All patients were followed at least 11.5 years after surgery.

RESULTS

All patients had hinge abduction deformity preoperatively. The mean Harris hip score improved from 70.23 ± 10.43 points preoperatively to 91.76 ± 7.25 points at the final follow-up. No patient had a limping gait at the final follow-up. The pre-operative visual analog scale score was 7.84 ± 0.22, and the last follow-up was 1.03 ± 0.25 (p < 0.001). According to the Stulberg classification, good radiological outcomes were obtained in 7 hips, whereas fair or poor outcomes were noted in 6 hips.

CONCLUSIONS

In severely affected hips of Perthes, patients who underwent femoral valgus extension osteotomy combined tectoplasty revealed satisfactory long-term clinical and radiological outcomes.