Abstract
Purpose of study: To test the hypothesis that previous hip involvement leads to earlier presentation and a better outcome for the contra-lateral hip in bilateral Legg-Calve-Perthes’ disease (LCPD).
Method: Case notes and radiographs of 250 patients with LCPD treated by a single surgeon between 1984 and 2003 were retrospectively reviewed. Thirty three patients (4 girls: 29 boys) with a minimum 1 year follow-up were identified with bilateral involvement from a prospectively collected database. Patients were grouped according to age at presentation (Group A-< 6 years; Group B- 6–8 years; Group C-> 8 years). All radiographs were reviewed and consensus was obtained on the presenting Waldenstrom stages. The severity of disease was rated by Catterall and lateral pillar classifications. The outcome was determined by the Stulberg classification. The right hip was the first affected in 25 of the 33 hips.
Results: These are summarized below.
Conclusions: The present report, with 33 patients, is the second largest series of patients with bilateral LCPD to our knowledge. The second hip involvement was milder than the first, but the improvement in outcome was statistically insignificant.
Correspondence should be addressed to: Mr J. B. Hunter, BSCOS, c/o BOA, The Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.
