Clinico-radiological correlation during the course and healing of Legg-Calve-Perthes’ disease treated by a non-intensive conservative method

Abstract

Introduction. The purpose of this study is to signify any clinical and radiological correlation, if present, in patients of Legg-Calve-Perthes’ disease (LCPD) who underwent an ambulatory conservative method of containment and their final outcome. Material and methods. Retrospective study over an 8-year period including patients of LCPD who were treated by an ambulatory conservative method showing signs of healing in the last radiological assessment was done. Clinically, gait, limb length discrepancy, range of motion of the hip, and Harris hip score were noted. The radiological parameters assessed in this study were epiphyseal index, epiphyseal quotient, acetabular head index, and epiphyseal extrusion index. Stulberg criteria was used to assess final outcome. Results. A total of 24 patients (17 males, 7 females) with a mean age of 7.9±3 years (5–9 years) who had a clinic-radiological diagnosis of LCPD were included in the study. There was a significant improvement of range of motion of the hip joint along with Harris hip score (t(18)= -16.77, p<0.001) but no significant changes in the radiological parameters during the course of the disease. There was no correlation between radiological parameters and Harris hip score. 79.1% (19/24) had a good outcome at final follow up. Conclusion. The function and clinical outcome during the course and healing of LCPD does not correlate with the radiographic changes and ambulatory conservative management leads to satisfactory improvement in functional activity. Age at onset and lateral pillar classification are important factors influencing final outcome in LCPD.