Arthrodiastasis of the hip

J Pediatr Orthop. 2011 Sep;31(2 Suppl):S229-34. doi: 10.1097/BPO.0b013e318223b45a.

Abstract

Background: Hip distraction in Legg-Calvé-Perthes disease unloads the joint, which negates the harmful effect of the stresses on the articular surface, which may promote the sound healing of the areas of necrosis.

Methods: Nonarticulated arthrodiastasis without soft tissue release using an Ilizarov external fixator was applied to 29 patients with Legg-Calvé-Perthes disease (older than 8 y at onset and lateral pillar type C or B).

Results: Follow-up period ranged from 2.5 to 11 years with an average of 7.5 years. Twenty-seven cases (93%) had improvement of the range of motion postoperatively. Preoperatively, all patients had constant pain, whereas at last follow-up 26 (86%) patients had no pain and 3 had an improvement. Stulberg classification was applied to 21 cases who reached skeletal maturity at last follow-up: 9 cases were type II, 7 cases were type III, 4 cases were type IV, and 1 case was type V.

Conclusions: Nonarticulated hip distraction without soft tissue release seems to be a valid treatment option in cases with Legg-Calvé-Perthes disease where poor results are expected from conventional treatment.

MeSH terms

  • Adolescent
  • Child
  • Female
  • Follow-Up Studies
  • Hip Joint / pathology
  • Hip Joint / surgery*
  • Humans
  • Ilizarov Technique*
  • Legg-Calve-Perthes Disease / pathology
  • Legg-Calve-Perthes Disease / surgery*
  • Male
  • Orthopedic Procedures / methods*
  • Pain, Postoperative / epidemiology
  • Range of Motion, Articular
  • Treatment Outcome