Subscribe to RSS
Cementless Total Hip Arthroplasty in Patients with Osteoarthrosis Secondary to Legg-Calvé-Perthes Disease Compared with Primary Osteoarthrosis: A Case-control StudyArticle in several languages: português | English
Objective To perform a comparative clinical, functional and radiographic evaluation of total hip arthroplasty (THA) performed with a cementless prosthesis in cases of osteoarthrosis secondary to Legg-Calvé-Perthes Disease (LCPD) and in cases of primary osteoarthrosis.
Methods In the present case-control study, we reviewed medical records of patients admitted to a university hospital between 2008 and 2015 to undergo THA due to LCPD sequelae and compared them with a control group of patients who underwent the same surgery due to primary hip osteoarthrosis. We recruited patients for clinical, functional, and radiographic analysis and we compared the evaluations in the immediate postoperative period and at the last follow-up visit, considering surgical time, size of prosthetic components, and complications.
Results We compared 22 patients in the study group (25 hips) with 22 patients (25 hips) in the control group, all of whom had undergone THA with the same cementless prosthesis. There was greater functional impairment in the group of patients with LCPD sequelae (p = 0.002). There were 4 intraoperative femoral periprosthetic fractures in the LCPD group and none in the primary osteoarthrosis group (p = 0.050).
Conclusions There is an increased risk of intraoperative periprosthetic femoral fracture and worse clinical-functional results in patients undergoing cementless THA due to osteoarthrosis secondary to LCPD sequelae than in those who have undergone the same surgery due to primary hip osteoarthrosis.
KeywordsLegg-Calvé-Perthes disease - osteoarthrosis - arthroplasty, replacement, hip - intraoperative complications
Work developed at the Instituto de Ortopedia e Traumatologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
Sources of Funding
The present study did not receive any kind of funding or financial support.
Received: 04 August 2020
Accepted: 11 February 2021
01 October 2021 (online)
© 2021. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil
- 1 Thillemann TM, Pedersen AB, Johnsen SP, Søballe K. Danish Hip Arthroplasty Registry. Implant survival after primary total hip arthroplasty due to childhood hip disorders: results from the Danish Hip Arthroplasty Registry. Acta Orthop 2008; 79 (06) 769-776
- 2 Furnes O, Lie SA, Espehaug B, Vollset SE, Engesaeter LB, Havelin LI. Hip disease and the prognosis of total hip replacements. A review of 53,698 primary total hip replacements reported to the Norwegian Arthroplasty Register 1987-99. J Bone Joint Surg Br 2001; 83 (04) 579-586
- 3 Boyd HS, Ulrich SD, Seyler TM, Marulanda GA, Mont MA. Resurfacing for Perthes disease: an alternative to standard hip arthroplasty. Clin Orthop Relat Res 2007; 465 (465) 80-85
- 4 Baghdadi YMK, Larson AN, Stans AA, Mabry TM. Total hip arthroplasty for the sequelae of Legg-Calvé-Perthes disease. Clin Orthop Relat Res 2013; 471 (09) 2980-2986
- 5 Uluçay C, Ozler T, Güven M, Akman B, Kocadal AO, Altıntaş F. Etiology of coxarthrosis in patients with total hip replacement. Acta Orthop Traumatol Turc 2013; 47 (05) 330-333
- 6 Gent E, Clarke NMP. Joint replacement for sequelae of childhood hip disorders. J Pediatr Orthop 2004; 24 (02) 235-240
- 7 Traina F, De Fine M, Sudanese A, Calderoni PP, Tassinari E, Toni A. Long-term results of total hip replacement in patients with Legg-Calvé-Perthes disease. J Bone Joint Surg Am 2011; 93 (07) e25
- 8 Pietrzak K, Strzyzewski W, Pucher A, Kaczmarek W. [Total hip replacement after Legg-Calvé-Perthes disease]. Pol Orthop Traumatol 2011; 76 (03) 129-133
- 9 Al-Khateeb H, Kwok IHY, Hanna SA, Sewell MD, Hashemi-Nejad A. Custom cementless THA in patients with Legg-Calve-Perthes Disease. J Arthroplasty 2014; 29 (04) 792-796
- 10 Lim YW, Kim MJ, Lee YS, Kim YS. Total Hip Arthroplasty in Patient with the Sequelae of Legg-Calvé-Perthes Disease. Hip Pelvis 2014; 26 (04) 214-219
- 11 Seufert CR, McGrory BJ. Treatment of Arthritis Associated With Legg-Calve-Perthes Disease With Modular Total Hip Arthroplasty. J Arthroplasty 2015; 30 (10) 1743-1746
- 12 Lee SJ, Yoo JJ, Kim HJ. Alumina-alumina total hip arthroplasty for the sequelae of Legg-Calve-Perthes disease: A comparative study with adult-onset osteonecrosis. J Orthop Sci 2016; 21 (06) 836-840
- 13 Lee KH, Jo WL, Ha YC, Lee YK, Goodman SB, Koo KH. Total hip arthroplasty using a monobloc cementless femoral stem for patients with childhood Perthes' disease. Bone Joint J 2017; 99-B (04) 440-444
- 14 Luo ZY, Wang HY, Wang D, Pan H, Pei FX, Zhou ZK. Monobloc implants in cementless total hip arthroplasty in patients with Legg-Calve-Perthes disease: a long-term follow-up. BMC Musculoskelet Disord 2017; 18 (01) 386
- 15 Hanna SA, Sarraf KM, Ramachandran M, Achan P. Systematic review of the outcome of total hip arthroplasty in patients with sequelae of Legg-Calvé-Perthes disease. Arch Orthop Trauma Surg 2017; 137 (08) 1149-1154
- 16 Farrell CM, Springer BD, Haidukewych GJ, Morrey BF. Motor nerve palsy following primary total hip arthroplasty. J Bone Joint Surg Am 2005; 87 (12) 2619-2625
- 17 Krych AJ, Howard JL, Trousdale RT, Cabanela ME, Berry DJ. Total hip arthroplasty with shortening subtrochanteric osteotomy in Crowe type-IV developmental dysplasia: surgical technique. J Bone Joint Surg Am 2010; 92 (Suppl 1 Pt 2): 176-187
- 18 Marx FC, de Oliveira LM, Bellini CG, Ribeiro MCC. Tradução e validação cultural do questionário algofuncional de Lequesne para osteoartrite de joelhos e quadris para a língua portuguesa. Rev Bras Reumatol 2006; 46 (04) 253-260
- 19 Kjellberg M, Englund E, Sayed-Noor AS. A new radiographic method of measuring femoral offset. The Sundsvall method. Hip Int 2009; 19 (04) 377-381
- 20 Sankar WN, Flynn JM. The development of acetabular retroversion in children with Legg-Calvé-Perthes disease. J Pediatr Orthop 2008; 28 (04) 440-443
- 21 Stulberg SD, Cooperman DR, Wallensten R. The natural history of Legg-Calvé-Perthes disease. J Bone Joint Surg Am 1981; 63 (07) 1095-1108
- 22 Froberg L, Christensen F, Pedersen NW, Overgaard S. Radiographic changes in the hip joint in children suffering from Perthes disease. J Pediatr Orthop B 2012; 21 (03) 220-225
- 23 Kitakoji T, Hattori T, Kitoh H, Katoh M, Ishiguro N. Which is a better method for Perthes' disease: femoral varus or Salter osteotomy?. Clin Orthop Relat Res 2005; (430) 163-170
- 24 Sanchez-Sotelo J, Berry DJ, Trousdale RT, Cabanela ME. Surgical treatment of developmental dysplasia of the hip in adults: II. Arthroplasty options. J Am Acad Orthop Surg 2002; 10 (05) 334-344
- 25 Zhu J, Wang Y, Pang J. et al. [Effectiveness of total hip arthroplasty for severe developmental dysplasia of hip in adults]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2014; 28 (03) 335-338
- 26 Kohlhof H, Ziebarth K, Gravius S, Wirtz DC, Siebenrock KA. Die operative Versorgung der sekundären Coxarthrose bei kongenitaler Hüftluxation (Crowe Typ IV). Oper Orthop Traumatol 2013; 25 (05) 469-482
- 27 Larson AN, McIntosh AL, Trousdale RT, Lewallen DG. Avascular necrosis most common indication for hip arthroplasty in patients with slipped capital femoral epiphysis. J Pediatr Orthop 2010; 30 (08) 767-773
- 28 Schoof B, Citak M, O'Loughlin PF. et al. Eleven year results of total hip arthroplasty in patients with secondary osteoarthritis due to slipped capital femoral epiphysis. Open Orthop J 2013; 7 (01) 158-162
- 29 Lewinnek GE, Lewis JL, Tarr R, Compere CL, Zimmerman JR. Dislocations after total hip-replacement arthroplasties. J Bone Joint Surg Am 1978; 60 (02) 217-220