Legg-Calvé-Perthes Disease

Abstract

Legg-Calvé-Perthes disease (LCPD) is a selflimited condition characterized by avascular necrosis (AVN) of the pediatric femoral head. Though the precise pathophysiology and etiology of this disease remains a topic of debate, it is thought to be a result of disrupted blood flow to the capital femoral epiphysis. Patients usually present with a limp, with or without associated pain, as well as decreased hip abduction and internal rotation. Initial infarction and fragmentation of the femoral epiphysis is followed by revascularization, reossification, and remodeling of the femoral head. However, significant residual deformity of the proximal femur often remains. During the active stages of disease, most patients respond well to conservative management, though depending on age, more severe cases may benefit from operative intervention. Patients diagnosed before the age of 8 tend to have a favorable prognosis, whereas patients diagnosed at an older age tend to develop significant arthritis and dysfunction later in life.