Long-term prognosis of Legg-Calvé-Perthes disease: a meta-analysis.

In the literature, long-term prognosis of Legg-Calvé-Perthes disease (LCPD) means prognosis for secondary osteoarthritis of the hip joint or leg-length inequality and its consequences. Most studies show results after conservative treatment. The long-term natural history of LCPD is not known. In spite of deformity, most patients do well in early adulthood. Radiographic and clinical osteoarthritis is increased in 20-year to 40-year follow-ups and degenerative joint disease develops in the majority of patients by the sixth or seventh decade of life. The reported average shortening of the affected leg has usually been 1 to 1.5 cm. There are no thorough long-term reports on low back pain after LCPD. The only evidence-based factors that are of prognostic importance in the long-term are age of the patient at the onset of the disease and shape of the femoral head at skeletal maturity.