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.
Study Type
OBSERVATIONAL
Enrollment
35
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.
Assaf Haroffeh Medical center
Ẕerifin, Israel
Clinical outcomes
The hip status was assessed by the Harris Hip Score (HHS)
Time frame: a follow-up 42.5 years from surgery
Clinical outcomes
The Short Form-36 (SF-36) was used to asses the general well being
Time frame: a follow-up 42.5 years from surgery
Radiographic outcomes
The degenerative changes were assessed by The Tonnis grade.
Time frame: a follow-up 42.5 years from surgery
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