Key result
Femoral head reduction osteotomy improved proximal femur shape and articular congruence in children with Perthes disease, though some developed secondary subluxation at 6 to 12 months.
Why the study?
Femoral head reduction osteotomy is effective for severe deformity from Perthes disease, but results have been reported in only a few small studies.
Does femoral head reduction osteotomy improve clinical and radiological outcomes in children with severe femoral head deformity due to Perthes disease?
Observational (n=20)
Does femoral head reduction osteotomy improve clinical and radiological outcomes in children with severe femoral head deformity due to Perthes disease?
Femoral head reduction osteotomy improves femoral head sphericity and congruence in children with severe Perthes disease, though simultaneous pelvic osteotomy may be needed in those with severe acetabular dysplasia.
May improve femoral head sphericity in severe Perthes cases; leaves open need for concurrent pelvic osteotomy to prevent subluxation.
Background. Lack of adequate treatment for children with Perthes disease leads to the formation of severe femoral head deformity with articular surfaces incongruity, followed by the development of femoroacetabular impingement and early hip osteoarthritis. To date, femoral head reduction osteotomy is the most effective treatment option for such patients. However, the results of its performance have been discussed in only a few case-control studies with small sample sizes in both international and domestic literature. The aim of the study was to evaluate the effectiveness and safety of femoral head reduction osteotomy and to analyze the further development of the hip joint in children operated for severe femoral head deformity due to Perthes disease. Methods. We have analyzed preoperative and postoperative results of clinical and radiological examination of 20 patients (20 hip joints) aged 8 to 12 years with deformed Perthes femoral head and articular surfaces incongruity. Femoral head reduction osteotomy was performed in all patients. Results. A radical proximal femoral reconstruction has led to significant improvement in the shape of the proximal femur with improved head sphericity and restoration of articular congruence. However, at the 6- to 12-month follow-up, some patients, primarily those with progressive lateral acetabular rim deformity, exhibited a decrease in the intraoperatively achieved Wiberg angle, an increase in the percentage of femoral head extrusion from the acetabulum, and varying degrees of Shenton line disruption. Conclusions. Performing femoral head reduction osteotomy with correct surgical technique is an effective reconstructive technique for the treatment of children with a severe saddle-shaped deformity of the femoral head and articular surfaces incongruity. In patients with Tönnis and Sharp angles exceeding the upper limit of the physiological norm, due to the formation of secondary subluxation, it is advisable to simultaneously perform femoral head reduction osteotomy and triple/periacetabular pelvic osteotomy. This treatment option should be chosen only after a critical analysis of potential risks.
No takes yet. Share an insight, caveat, or question.
Bortulev et al. (2025) conducted an observational in Perthes disease with severe femoral head deformity and articular surfaces incongruity (n=20). Femoral head reduction osteotomy was evaluated on Clinical and radiological examination (shape of proximal femur, head sphericity, articular congruence). Femoral head reduction osteotomy improved proximal femur shape and articular congruence in children with Perthes disease, though some developed secondary subluxation at 6 to 12 months.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: