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Background: Varus derotation osteotomy (VDRO) is one of the most popular surgical treatments for Legg-Calvé-Perthes disease yet its long term results have not been assessed. Our purpose was to determine the long term clinical and radiographic outcomes of these patients.
Methods: Forty patients (43 hips) who had undergone VDRO for LCPD who participated in a long term follow-up study a decade ago were approached for the present study.
All patients were treated in our institution during 1959 to 1983 with proximal VDRO.
The patients were invited to for a medical interview and a physical examination. They were also asked to fill out questionnaires and to provide or undergo a standing anteroposterior (AP) pelvic and a lateral hip radiographs during the visit.
Patients were asked to self-grade their hip pain as none, mild, moderate or severe and to grade their back pain using the Visual Analogue Scale (VAS) between 0-10. Details regarding daily function, physical activity, work status and family history were obtained. All participants completed the Harris Hip Score (HHS) with a maximum score of 100 and the Short Form-36 which is composed of 8 sections and has a maximum score of 100.
The physical examination included an assessment of the hip range of motion, leg length discrepancy and the presence of a Trendelenburg sign.
Radiographic parameters evaluated were the Tonnis grade (with a score between 0-3), head size ratio, and the center-edge (CE) angle.
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Proximal varus derotational osteotomy | Procedure | The purpose of surgery was to relocate the protruded, deformed femoral head from its lateral position back to the acetabulum to achieve containment. Surgery was preceded by a hip arthrography with dynamic examination to find the suitable containment position and plan the correct osteotomy angles accordingly. A sub trochanteric osteotomy was performed then after in an open or closed wedge form, with fixation in an angle that gave best coverage. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Clinical outcomes | The hip status was assessed by the Harris Hip Score (HHS) | a follow-up 42.5 years from surgery |
| Clinical outcomes | The Short Form-36 (SF-36) was used to asses the general well being | a follow-up 42.5 years from surgery |
| Radiographic outcomes | The degenerative changes were assessed by The Tonnis grade. | a follow-up 42.5 years from surgery |
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Inclusion Criteria:
Exclusion Criteria:
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Forty patients (43 hips) who had undergone VDRO for LCPD who participated in a long term follow-up study a decade ago. All patients were treated in our institution during 1959 to 1983 with proximal VDRO.
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| Name | Affiliation | Role |
|---|---|---|
| Noam Shohat, MD | Tel Aviv University, Israel | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Assaf Haroffeh Medical center | Ẕerifin | 70300 | Israel |
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| ID | Term |
|---|---|
| D007873 | Legg-Calve-Perthes Disease |
| ID | Term |
|---|---|
| D005271 | Femur Head Necrosis |
| D010020 | Osteonecrosis |
| D001847 | Bone Diseases |
| D009140 | Musculoskeletal Diseases |
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