2026-06-12 | [Extracorporeal magnetotransduction therapy in juvenile Perthes' disease : A case report].
Morbus Perthes is an aseptical osteonecrosis in childhood that has great variablity in theextent, course and healing results. A spontaneous resolution is possible, which, however, mandates high patience for both the affected child and the caring parents. Regarding the lack of conservative treatment methods, a new non-invasive therapy approach using novel extracorporeal magnetotransduction therapy (EMTT) was performed on a 4-year-old patient with Perthes disease. A significant pain reduction was achieved within 6 weeks in line with MRI improvements with a total of 9 EMTT sessions. EMTT represents a promising non-invasive treatment option for children with Perthes disease, and future controlled studies in this special patient cohort are pending and warranted.
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2026-06-01 | The Role of Hip Arthrodiastasis in Management of Late-Onset Legg-Calvé-Perthes Disease: A Prospective Case Series.
Late-onset Legg-Calvé-Perthes disease (LCPD), defined as onset after the age of 8 years or younger, is associated with a poor prognosis and limited remodeling potential. The role of hip arthrodiastasis in this age group remains controversial. This prospective case series enrolled patients consecutively and collected data at predefined follow-up intervals. It included 24 patients with late-onset LCPD treated with articulated hip arthrodiastasis using a hinged Ilizarov external fixator combined with percutaneous adductor tenotomy. This reflects a deliberate institutional shift in treatment strategy rather than selective case allocation, which may reduce selection bias but limits the availability of a contemporary control group. All patients were older than 8 years at disease onset and classified as Herring lateral pillar B or C. Clinical outcomes were assessed using the Harris Hip Score (HHS) and range of motion (ROM). Radiographic evaluation included the Sharp acetabular angle, Reimer uncoverage index, epiphyseal index, and modified Stulberg classification at final follow-up. The mean follow-up was 24 months (range: 18 to 30). The mean HHS improved significantly from 47.2 preoperatively to 86.7 at final follow-up (P<0.001). Significant improvements were observed in hip flexion, abduction, and internal rotation (all P<0.001). Radiographically, mean femoral head uncoverage improved from 33.3% to 25.0% (P<0.001), and the Sharp acetabular angle decreased from 42.3 to 37.6 degrees (P<0.001). According to the modified Stulberg classification, 19 hips (79%) had good outcomes (Stulberg II to III), while 5 hips (21%) had poor outcomes (Stulberg IV to V). Complications included pin-tract infections managed with local care and oral antibiotics, as well as a small number of patients requiring additional secondary procedures. Articulated hip arthrodiastasis with adductor tenotomy resulted in favorable short-term clinical and radiographic outcomes in most patients with late-onset LCPD. This technique improved hip motion and radiographic parameters suggestive of improved femoral head containment, without the need for femoral or pelvic osteotomy, and may represent a useful treatment option in this challenging patient population. Level IV-therapeutic case series.
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2026-05-14 | TOTAL HIP ARTHROPLASTY IN LEGG-CALVÉ-PERTHES DISEASE: A STUDY FROM THE AUSTRALIAN ORTHOPAEDIC ASSOCIATION NATIONAL JOINT REPLACEMENT REGISTRY
Background Legg-Calve-Perthes disease (LCPD) is a paediatric hip disorder characterised by idiopathic ischaemic necrosis and early osteoarthritis. There is limited evidence on revision outcomes for total hip arthroplasty (THA) in LCPD compared to primary osteoarthritis (OA). Methods Data from the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) was analysed to determine cumulative percent revision rate (CPR), revision indication and functional outcome scores for THA performed for patients undergoing THA for Perthes disease and primary OA between 2003 and 2023. Results There were 1159 THAs for LCPD and 521,603 for primary OA available for analysis. Patients with LCPD incurred a higher CPR in the first two weeks postoperatively, but no difference was observed beyond this time. The CPR adjusted for age, head size, sex and femoral fixation for patients with LCPD at 18 years was 8.5% (95% CI 5.6,12.8) compared to 7.1% (95% CI 7.0, 7.3) for patients with primary OA. There was no difference in the reason for revision. Functional outcome scores were similar, although those patients with LCPD had slightly lower improvement in the Oxford Hip Score. Conclusion Revision rates following THA are comparable between patients with LCPD and primary OA at eighteen years post-operatively. The higher early revision rate in LCPD patients warrants further investigation into contributing factors including surgical planning, types of prostheses, and the influence of previous surgery.
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