GAIT CHANGES AFTER GREATER TROCHANTER TRANSFER IN PATIENTS WITH UNILATERAL LEGG-CALVÉ-PERTHES DISEASE

Abstract

INTRODUCTION Distal and lateral transfer of the greater trochanter as a surgical treatment for trochanteric overgrowth in patients complicated with Legg-Perthes disease has been known to be effective in eliminating fatigue hip pain. However, past studies were only confined to the outcomes related to clinical and radiological changes. The purpose of this study was to evaluate the outcome of greater trochanter transfer in terms of computerized gait analysis. METHODS Cases with bilateral involvement and patients who had received any operation previously on the affected side were excluded. Nine hips in 9 patients who underwent the index operation constituted the study population. All of the patients complained of limping and fatigue pain on walking. On physical examination, Trendelenberg sign was positive in all patients. The mean age at surgery was 16.9 years (10 to 32), and the patients were followed up to at least 2 years after the operation. The mean follow-up was 39 months (27 to 52). Clinically, existence of limping, fatigue pain on walking, and Trendelenberg sign were evaluated. Radiographic evaluation was performed by measuring the radius of the femoral head, the neck-shaft angle (NSA), articulotrochanteric distance (ATD), lateral displacement, and the greater trochater overgrowth (GTOG). Center-edge (CE) angle, and the angle of the Idelberger and Frank (ACM angle) were measured to evaluate the acetabular-head relationship. Stulberg classification system was used to assess the degree of the head deformities. Three-dimensional computerized gait analysis was performed using the VICON 370 motion analysis system (Oxford Metrics Ltd., Oxford, England) before and after the operation. The pelvic obliquity angle and hip abduction/adduction angle were analyzed. The peak hip moment during single stance was recorded. RESULTS AND DISCUSSION