Femoral Head Reduction Osteotomy versus Relative Femoral Neck Lengthening in Management of Perthes Sequelae: A Systematic Review and Meta-Analysis

Abstract

Background The single most important predictor determining the long-term prognosis following healed Perthes disease is the shape of the proximal femur. A high riding greater trochanter, a short femoral neck, and proximal femur abnormalities can induce both intraarticular and extra-articular femoro-acetabular impingement, resulting in degenerative hip discomfort, limited range of motion, and decreased abductor function. Aim of the Work to perform systematic review about surgical techniques in treatment of perthes in young adult population. Patients and Methods We searched the MEDLINE database via PubMed, EMBASE, and Cochrane Library using the following Keywords; “Legg-Calve-Perthes”, “Perthes' disease”, “osteotomy”, “surgical hip dislocation in perthes” and “young adult population”. Results Seven full text articles met our inclusion criteria and were included in the final analysis. Conclusion The single most important predictor determining the long-term prognosis following healed Perthes disease is the shape of the proximal femur. A high- riding greater trochanter, a short femoral neck, and proximal femur abnormalities can induce both intraarticular and extra-articular femoro- acetabular impingement, resulting in degenerative hip discomfort, limited range of motion, and decreased abductor function.