Legg-Calvé-Perthes disease in patients under 5 years of age does not always result in a good outcome. Personal experience and meta-analysis of the literature.

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This study attempted to analyze objectively the long-standing impression that children under 5 years of age, who have Legg-Calvé-Perthes disease, generally do well. Thirty patients, with 36 hips and onset of disease prior to their fifth birthday were reviewed at skeletal maturity. More than 50% of the hips were classified in Catterall group 3 or 4, and Herring group C. The end evaluation by the Stulberg classification showed 44.5% good, 22.2% fair and 33.3% poor results. By the Mose rating the results were respectively 27.8% good, 30.6% fair and 41.6% poor.A meta-analysis of the literature showed a very broad spectrum of results, leading to the conclusion, first, that comparison is difficult and, second, that young age is not a free ticket to a good result.

Young age at onset does not guarantee good Legg-Calvé-Perthes outcomes; challenges consensus and warrants refined prognostic models.