Future biologic treatments for Perthes disease.

Standard surgical approaches for Perthes disease consist of nonoperative physical treatments or surgical treatment. Several investigators have been working on a better understanding of the pathophysiology and pathobiology of Perthes disease. Most of the focus has been on antiresorptive treatments. Other treatment avenues, however, include controlling the inflammatory phase of Perthes disease, increasing revascularization of necrotic bone, and anabolic strategies to increase bone formation. This article presents a current pathophysiological model of Perthes disease, reviews experimental strategies in pharmaceutical treatments, and suggests future areas for research.