Legg-Calve-Perthes disease, oftentimes simply referred to as Perthes, is a condition that affects the health of your hip joint. It typically develops in children and teens and is four more times as common in boys than in girls. It usually only affects one side of the hip, but it can develop on both sides.
Perthes occurs when blood flow to the ball of the hip is restricted or stopped, which eventually kickstarts a bevy of problems within the hip joint. While it can sometimes be effectively managed with conservative methods, it can also lead to the need for an earlier hip replacement in adulthood. Below, we take a closer look at Perthes, how it affects the hip joint and what you should know if you may need to undergo a hip replacement procedure in adulthood as a result of the condition.
The Stages Of Perthes
Perthes progresses through four specific stages which can impact the overall health of your hip joint. Those stages are:
- Necrosis – As blood supply to the femoral head is disrupted, bone necrosis occurs, leading to inflammation, stiffness and pain in the hip joint. This stage typically lasts a few months, and femoral head changes will be visible upon an X-ray exam.
- Fragmentation – Your body attempts to remove the dead bone cells and replace them with healthy bone cells. Your femoral head begins to remodel and reform a round shape, but pain and inflammation can persist. This phase can last for up to two years.
- Reossification – Your femoral head continues to remodel itself as blood flow is restored to the area, slowly reshaping over the course of 1-3 years.
- Remodeling – Normal bone cells replace the new bone cells, and the femoral head can end up flattening a bit as opposed to having a traditional ball shape.
So while kids can oftentimes successfully overcome Perthes disease with conservative treatments like rest, physical therapy, bracing and anti-inflammatories, there’s still the possibility that the remodeled femoral head will have a less than ideal shape. As they go into adulthood, this flattened or mushroom shaped bone can lead to expedited arthritis or other degenerative issues that would result in the need for a hip replacement procedure.
The recovery plan will look rather similar for hip replacement patients whether or not their reason for hip replacement derives from childhood Perthes disease or not. You’ll pursue aggressive physical therapy under the guidance of a physical therapist and follow some basic movement restrictions in the short- and long-term. Most patients are much more mobile and have significantly less pain after their operation and rehab, so know that you have options if Perthes contributed to arthritis-related issues in your hip.
For more information about Perthes disease or about hip replacement surgery in general, reach out to Dr. Botero and his team today at (865) 558-4444.
