Legg-Calvé-Perthes disease

Legg-Calvé-Perthes disease (LCPD), also known as Perthes disease, coxa plana, or avascular necrosis of the femoral head in children, is a childhood hip disorder in which the blood supply to the femoral head (the ball-shaped top of the thighbone) is temporarily disrupted. This loss of blood flow causes the bone to die (osteonecrosis), weaken, and eventually fragment. Over time, the body attempts to resorb the dead bone and replace it with new bone through a process of revascularization and reossification. The disease primarily affects the musculoskeletal system, specifically the hip joint, and predominantly occurs in children between the ages of 4 and 10 years. Boys are affected approximately four to five times more frequently than girls. Key symptoms include hip pain (which may also be referred to the groin, thigh, or knee), limping, reduced range of motion in the affected hip, and leg-length discrepancy. The condition is unilateral in approximately 85-90% of cases. The severity of the disease depends on the extent of femoral head involvement and the age of onset; younger children generally have better outcomes because they have greater potential for femoral head remodeling. If the femoral head does not heal in a spherical shape, it can lead to early-onset osteoarthritis of the hip in adulthood. The exact cause of Legg-Calvé-Perthes disease remains unclear, though it is considered multifactorial, with potential contributions from genetic susceptibility, thrombophilia, and environmental factors. Treatment depends on the child's age, the degree of femoral head involvement, and the stage of the disease. Conservative management includes activity modification, physical therapy, anti-inflammatory medications, and the use of braces or casts to keep the femoral head well-seated within the acetabulum (containment). Surgical options, such as femoral or pelvic osteotomy, may be considered in older children or those with more severe involvement to improve containment and promote spherical remodeling of the femoral head. Long-term follow-up is essential to monitor hip joint development and function.

Data sourced from FDA regulatory filings and ClinicalTrials.gov. Updated periodically.

Common questions about Legg-Calvé-Perthes disease