Extent of physeal involvement in Legg–Calvé–Perthes disease

Kwang Won Park, Chastity Amor Rejuso, Rey An Nino Garcia, Tae Wan Kim, Hae Ryong Song

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Purpose: The growth plate involvement (GPI) index is reportedly a reliable predictor of final radiographic outcome in Legg–Calvé–Perthes disease (LCPD). We determined whether (1) the GPI index was associated with the lateral pillar classification, (2) the GPI index could predict the final radiographic outcome, and (3) the geometry of proximal femur was affected by presence of physeal involvement.

Methods: We reviewed 47 patients with unilateral LCPD who were treated conservatively. The mean duration of follow-up was 9.5 years (range, five to 13 years). The affected hips were categorized into those with and without physeal involvement. Herring classifications were determined and the GPI indices were estimated at the stage of maximum fragmentation. The Stulberg classification, leg length discrepancy (LLD), articulotrochanteric distance (ATD) index, neck-shaft angle (NSA), neck width and height were determined at skeletal maturity.

Results: The GPI indices were lower in Herring groups A and B (p < 0.001) and Stulberg classes I and II (p = 0.002), and these values were increased in the Herring group B/C and C and Stulberg classes III, IV and V. However, the age of onset, LLD and ATD index at skeletal maturity were not associated with the GPI index. The NSA of the affected hips with physeal involvement was significantly different compared to that of unaffected hips (p < 0.001).

Conclusions: The GPI index could be used to determine the extent of physeal involvement in LCPD, and might be considered one of the prognostic values of radiographic development in patients with LCPD who are treated conservatively.

Original languageEnglish
Pages (from-to)2303-2308
Number of pages6
JournalInternational Orthopaedics
Volume38
Issue number11
DOIs
Publication statusPublished - 2014

Fingerprint

Growth Plate
Hip
Neck
Leg
Age of Onset
Femur
Geometry

Keywords

  • Growth plate involvement
  • Legg–Calvé–Perthes disease
  • Physis

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

Extent of physeal involvement in Legg–Calvé–Perthes disease. / Park, Kwang Won; Rejuso, Chastity Amor; Garcia, Rey An Nino; Kim, Tae Wan; Song, Hae Ryong.

In: International Orthopaedics, Vol. 38, No. 11, 2014, p. 2303-2308.

Research output: Contribution to journalArticle

Park, Kwang Won ; Rejuso, Chastity Amor ; Garcia, Rey An Nino ; Kim, Tae Wan ; Song, Hae Ryong. / Extent of physeal involvement in Legg–Calvé–Perthes disease. In: International Orthopaedics. 2014 ; Vol. 38, No. 11. pp. 2303-2308.
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abstract = "Purpose: The growth plate involvement (GPI) index is reportedly a reliable predictor of final radiographic outcome in Legg–Calv{\'e}–Perthes disease (LCPD). We determined whether (1) the GPI index was associated with the lateral pillar classification, (2) the GPI index could predict the final radiographic outcome, and (3) the geometry of proximal femur was affected by presence of physeal involvement.Methods: We reviewed 47 patients with unilateral LCPD who were treated conservatively. The mean duration of follow-up was 9.5 years (range, five to 13 years). The affected hips were categorized into those with and without physeal involvement. Herring classifications were determined and the GPI indices were estimated at the stage of maximum fragmentation. The Stulberg classification, leg length discrepancy (LLD), articulotrochanteric distance (ATD) index, neck-shaft angle (NSA), neck width and height were determined at skeletal maturity.Results: The GPI indices were lower in Herring groups A and B (p < 0.001) and Stulberg classes I and II (p = 0.002), and these values were increased in the Herring group B/C and C and Stulberg classes III, IV and V. However, the age of onset, LLD and ATD index at skeletal maturity were not associated with the GPI index. The NSA of the affected hips with physeal involvement was significantly different compared to that of unaffected hips (p < 0.001).Conclusions: The GPI index could be used to determine the extent of physeal involvement in LCPD, and might be considered one of the prognostic values of radiographic development in patients with LCPD who are treated conservatively.",
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