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Legg-Calvé-Perthes Disease

What is Legg-Calvé-Perthes disease?

Legg-Calvé-Perthes disease, often called Perthes disease, is a disease of the hip.

It occurs when blood temporarily stops flowing to the ball (femoral head) at the top of the thighbone that fits into the hip socket. If the bone does not get enough blood, it can collapse so that it no longer moves smoothly in the hip socket.

Children with Legg-Calvé-Perthes disease may develop premature arthritis and lose some movement in their hips.

The disease can occur in both hips, but usually not at the same time.

How do you evaluate Legg-Calvé-Perthes disease?

Natural history of early onset LCP disease.
Natural history of early onset LCP disease.

We will look for a slight limp in your child’s walk, a common sign of Perthes disease. We also will ask questions about any pain your child might be feeling. Then we will examine your child.

The doctor will gently move your child’s legs, comparing the movement on the sore side with the movement on the other side.

We may take X-rays to make sure Perthes disease is the problem. If the X-rays look normal, we may ask for a bone scan or an MRI to get more information.

Who gets Legg-Calvé-Perthes disease?

Causes of LCP disease.
Causes of LCP disease.

Although any child can get Perthes disease, boys with the disease outnumber girls four to one. Usually, they are thin, wiry, very active boys who are smaller than others their age.

Perthes disease usually develops when children are between the ages of 4 and 8, but children as young as age 2 and as old as age 12 can develop the disease.

What is your experience with Legg-Calvé-Perthes disease?

We have decades of experience treating children with Legg-Calvé-Perthes disease.

Doctors at Children’s Hospital developed the Staheli Shelf procedure, a surgical technique used internationally to treat older children with Perthes disease. The procedure is named after the former director of our Department of Orthopedics, Dr. Lynn T. Staheli.

In this operation, doctors add a shelf of bone to the outer part of the socket to deepen it so it can better hold the ball (femoral head) at the top of the thighbone. This helps prevent some of the deformity of the ball that can occur with Perthes disease.

How do you treat Legg-Calvé-Perthes disease?

For many years, doctors researching Perthes disease have been looking for the best way to keep the femoral head working in the hip socket.

Using medicines and reducing activity to decrease pain seems to work the best in children younger than age 6. Sometimes doctors use a brace to slow a child down in an effort to decrease pain and improve movement of the hip.

Children who are older than age 6 or who have more severe cases of Perthes disease are more likely to benefit from surgery. The goal of surgery is to prevent the dislocation or collapse of the hip — to keep the femoral head in your child’s hip socket.

These surgeries either tilt the ball so it is deeper in the socket or rotate the socket so that it will cover the ball better when your child walks. Sometimes doctors try to do both.