The Long Term Outcome of Varus Derotational Osteotomy for Legg-Calvé-Perthes' Disease

Study Overview
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Brief Summary
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Background: Varus derotation osteotomy (VDRO) is one of the most popular surgical treatments for Legg-Calvé-Perthes disease yet its long term results have not been assessed. Our purpose was to determine the long term clinical and radiographic outcomes of these patients. Methods: Forty patients (43 hips) who had undergone VDRO for LCPD who participated in a long term follow-up study a decade ago were approached for the present study. All patients were treated in our institution during 1959 to 1983 with proximal VDRO. The patients were invited to for a medical interview and a physical examination. They were also asked to fill out questionnaires and to provide or undergo a standing anteroposterior (AP) pelvic and a lateral hip radiographs during the visit. Patients were asked to self-grade their hip pain as none, mild, moderate or severe and to grade their back pain using the Visual Analogue Scale (VAS) between 0-10. Details regarding daily function, physical activity, work status and family history were obtained. All participants completed the Harris Hip Score (HHS) with a maximum score of 100 and the Short Form-36 which is composed of 8 sections and has a maximum score of 100. The physical examination included an assessment of the hip range of motion, leg length discrepancy and the presence of a Trendelenburg sign. Radiographic parameters evaluated were the Tonnis grade (with a score between 0-3), head size ratio, and the center-edge (CE) angle.

Official Title
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The Long Term Outcome of Varus Derotational Osteotomy for Legg-Calvé-Perthes' Disease

Conditions
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Legg-Calvé-Perthes Disease

Intervention / Treatment
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* Procedure: Proximal varus derotational osteotomy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All patients were treated in our institution during 1959 to 1983 with proximal VDRO and were examined a decade ago Exclusion Criteria: -
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Procedure: Proximal varus derotational osteotomy|The purpose of surgery was to relocate the protruded, deformed femoral head from its lateral position back to the acetabulum to achieve containment. Surgery was preceded by a hip arthrography with dynamic examination to find the suitable containment position and plan the correct osteotomy angles accordingly. A sub trochanteric osteotomy was performed then after in an open or closed wedge form, with fixation in an angle that gave best coverage.|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Clinical outcomes | The hip status was assessed by the Harris Hip Score (HHS) | a follow-up 42.5 years from surgery | 
| Clinical outcomes | The Short Form-36 (SF-36) was used to asses the general well being | a follow-up 42.5 years from surgery | 
| Radiographic outcomes | The degenerative changes were assessed by The Tonnis grade. | a follow-up 42.5 years from surgery |