Extent of physeal involvement in Legg–Calvé–Perthes disease

Kwang Won Park; Chastity Amor Rejuso; Rey An Nino Garcia; Tae Wan Kim; Hae Ryong Song

doi:10.1007/s00264-014-2480-1

Extent of physeal involvement in Legg–Calvé–Perthes disease

Kwang Won Park, Chastity Amor Rejuso, Rey An Nino Garcia, Tae Wan Kim, Hae Ryong Song

Department of Biomedical Sciences

Research output: Contribution to journal › Article › peer-review

9 Citations (Scopus)

Abstract

Purpose: The growth plate involvement (GPI) index is reportedly a reliable predictor of final radiographic outcome in Legg–Calvé–Perthes disease (LCPD). We determined whether (1) the GPI index was associated with the lateral pillar classification, (2) the GPI index could predict the final radiographic outcome, and (3) the geometry of proximal femur was affected by presence of physeal involvement.

Methods: We reviewed 47 patients with unilateral LCPD who were treated conservatively. The mean duration of follow-up was 9.5 years (range, five to 13 years). The affected hips were categorized into those with and without physeal involvement. Herring classifications were determined and the GPI indices were estimated at the stage of maximum fragmentation. The Stulberg classification, leg length discrepancy (LLD), articulotrochanteric distance (ATD) index, neck-shaft angle (NSA), neck width and height were determined at skeletal maturity.

Results: The GPI indices were lower in Herring groups A and B (p < 0.001) and Stulberg classes I and II (p = 0.002), and these values were increased in the Herring group B/C and C and Stulberg classes III, IV and V. However, the age of onset, LLD and ATD index at skeletal maturity were not associated with the GPI index. The NSA of the affected hips with physeal involvement was significantly different compared to that of unaffected hips (p < 0.001).

Conclusions: The GPI index could be used to determine the extent of physeal involvement in LCPD, and might be considered one of the prognostic values of radiographic development in patients with LCPD who are treated conservatively.

Original language	English
Pages (from-to)	2303-2308
Number of pages	6
Journal	International Orthopaedics
Volume	38
Issue number	11
DOIs	https://doi.org/10.1007/s00264-014-2480-1
Publication status	Published - 2014 Nov

Bibliographical note

Funding Information:
This study was also supported by a grant of the Korean Health Technology R&D Project, Ministry of Health & Welfare, Republic of Korea (HI13C1501).

Funding Information:
Acknowledgments The institution of one or more of the authors (H-R S) has received funding from the Korea Healthcare Technology R & D Project, Ministry of Health & Welfare, Republic of Korea (HI11C0388).

Publisher Copyright:
© 2014, SICOT aisbl.

Keywords

Growth plate involvement
Legg–Calvé–Perthes disease
Physis

ASJC Scopus subject areas

Surgery
Orthopedics and Sports Medicine

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10.1007/s00264-014-2480-1

Cite this

@article{7d01808de218494b916126428d3f721a,

title = "Extent of physeal involvement in Legg–Calv{\'e}–Perthes disease",

abstract = "Purpose: The growth plate involvement (GPI) index is reportedly a reliable predictor of final radiographic outcome in Legg–Calv{\'e}–Perthes disease (LCPD). We determined whether (1) the GPI index was associated with the lateral pillar classification, (2) the GPI index could predict the final radiographic outcome, and (3) the geometry of proximal femur was affected by presence of physeal involvement.Methods: We reviewed 47 patients with unilateral LCPD who were treated conservatively. The mean duration of follow-up was 9.5 years (range, five to 13 years). The affected hips were categorized into those with and without physeal involvement. Herring classifications were determined and the GPI indices were estimated at the stage of maximum fragmentation. The Stulberg classification, leg length discrepancy (LLD), articulotrochanteric distance (ATD) index, neck-shaft angle (NSA), neck width and height were determined at skeletal maturity.Results: The GPI indices were lower in Herring groups A and B (p < 0.001) and Stulberg classes I and II (p = 0.002), and these values were increased in the Herring group B/C and C and Stulberg classes III, IV and V. However, the age of onset, LLD and ATD index at skeletal maturity were not associated with the GPI index. The NSA of the affected hips with physeal involvement was significantly different compared to that of unaffected hips (p < 0.001).Conclusions: The GPI index could be used to determine the extent of physeal involvement in LCPD, and might be considered one of the prognostic values of radiographic development in patients with LCPD who are treated conservatively.",

keywords = "Growth plate involvement, Legg–Calv{\'e}–Perthes disease, Physis",

author = "Park, {Kwang Won} and Rejuso, {Chastity Amor} and Garcia, {Rey An Nino} and Kim, {Tae Wan} and Song, {Hae Ryong}",

note = "Funding Information: This study was also supported by a grant of the Korean Health Technology R&D Project, Ministry of Health & Welfare, Republic of Korea (HI13C1501). Funding Information: Acknowledgments The institution of one or more of the authors (H-R S) has received funding from the Korea Healthcare Technology R & D Project, Ministry of Health & Welfare, Republic of Korea (HI11C0388). Publisher Copyright: {\textcopyright} 2014, SICOT aisbl.",

year = "2014",

month = nov,

doi = "10.1007/s00264-014-2480-1",

language = "English",

volume = "38",

pages = "2303--2308",

journal = "International Orthopaedics",

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T1 - Extent of physeal involvement in Legg–Calvé–Perthes disease

AU - Park, Kwang Won

AU - Rejuso, Chastity Amor

AU - Garcia, Rey An Nino

AU - Kim, Tae Wan

AU - Song, Hae Ryong

N1 - Funding Information: This study was also supported by a grant of the Korean Health Technology R&D Project, Ministry of Health & Welfare, Republic of Korea (HI13C1501). Funding Information: Acknowledgments The institution of one or more of the authors (H-R S) has received funding from the Korea Healthcare Technology R & D Project, Ministry of Health & Welfare, Republic of Korea (HI11C0388). Publisher Copyright: © 2014, SICOT aisbl.

PY - 2014/11

Y1 - 2014/11

N2 - Purpose: The growth plate involvement (GPI) index is reportedly a reliable predictor of final radiographic outcome in Legg–Calvé–Perthes disease (LCPD). We determined whether (1) the GPI index was associated with the lateral pillar classification, (2) the GPI index could predict the final radiographic outcome, and (3) the geometry of proximal femur was affected by presence of physeal involvement.Methods: We reviewed 47 patients with unilateral LCPD who were treated conservatively. The mean duration of follow-up was 9.5 years (range, five to 13 years). The affected hips were categorized into those with and without physeal involvement. Herring classifications were determined and the GPI indices were estimated at the stage of maximum fragmentation. The Stulberg classification, leg length discrepancy (LLD), articulotrochanteric distance (ATD) index, neck-shaft angle (NSA), neck width and height were determined at skeletal maturity.Results: The GPI indices were lower in Herring groups A and B (p < 0.001) and Stulberg classes I and II (p = 0.002), and these values were increased in the Herring group B/C and C and Stulberg classes III, IV and V. However, the age of onset, LLD and ATD index at skeletal maturity were not associated with the GPI index. The NSA of the affected hips with physeal involvement was significantly different compared to that of unaffected hips (p < 0.001).Conclusions: The GPI index could be used to determine the extent of physeal involvement in LCPD, and might be considered one of the prognostic values of radiographic development in patients with LCPD who are treated conservatively.

AB - Purpose: The growth plate involvement (GPI) index is reportedly a reliable predictor of final radiographic outcome in Legg–Calvé–Perthes disease (LCPD). We determined whether (1) the GPI index was associated with the lateral pillar classification, (2) the GPI index could predict the final radiographic outcome, and (3) the geometry of proximal femur was affected by presence of physeal involvement.Methods: We reviewed 47 patients with unilateral LCPD who were treated conservatively. The mean duration of follow-up was 9.5 years (range, five to 13 years). The affected hips were categorized into those with and without physeal involvement. Herring classifications were determined and the GPI indices were estimated at the stage of maximum fragmentation. The Stulberg classification, leg length discrepancy (LLD), articulotrochanteric distance (ATD) index, neck-shaft angle (NSA), neck width and height were determined at skeletal maturity.Results: The GPI indices were lower in Herring groups A and B (p < 0.001) and Stulberg classes I and II (p = 0.002), and these values were increased in the Herring group B/C and C and Stulberg classes III, IV and V. However, the age of onset, LLD and ATD index at skeletal maturity were not associated with the GPI index. The NSA of the affected hips with physeal involvement was significantly different compared to that of unaffected hips (p < 0.001).Conclusions: The GPI index could be used to determine the extent of physeal involvement in LCPD, and might be considered one of the prognostic values of radiographic development in patients with LCPD who are treated conservatively.

KW - Growth plate involvement

KW - Legg–Calvé–Perthes disease

KW - Physis

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DO - 10.1007/s00264-014-2480-1

M3 - Article

C2 - 25128965

AN - SCOPUS:84939872876

SN - 0341-2695

VL - 38

SP - 2303

EP - 2308

JO - International Orthopaedics

JF - International Orthopaedics

IS - 11

ER -

Extent of physeal involvement in Legg–Calvé–Perthes disease

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

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