Osteochondroplasty and relative neck lengthening in the treatment of late sequelae of Perthes disease

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Abstract

Purpose
The goal was to evaluate the short-term results of femoral head osteochodroplasty and trochanteric advancement in the treatment of late sequelae of Perthes disease associated with aspherical head and hinged abduction.
Patients and methods
The authors carried out a prospective study to evaluate the clinical and radiological results of 15 patients with late sequelae of Perthes disease treated by osteochodroplasty of the head neck junction with distal advancement of the greater trochanter through a surgical hip dislocation approach.
Results
The mean age of the patients was 20 years, with a mean follow-up of 36 months. We achieved a mean improvement of harris hip scores (HHS) from 65.6 preoperatively to 87.6 postoperatively, with a marked improvement in range of motion, especially for abduction (from 13.8° preoperatively to 30.3° postoperatively) and internal rotation (from 16.4° preoperatively to 28.6° postoperatively). The mean center trochanteric distance (CTD) improved from −18 to 0.26 mm postoperatively. Seven cases progressed one grade of osteoarthritis (OA); two of them required total hip replacement.
Conclusion
Combined osteochondroplasty and distal advancement for the treatment of late sequel of Perthes disease improve hip function, decrease pain, and improve radiological parameters of the hip.

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