Background Legg-Calve-Perthes disease (LCPD) is a paediatric hip disorder characterised by idiopathic ischaemic necrosis and early osteoarthritis. There is limited evidence on revision outcomes for total hip arthroplasty (THA) in LCPD compared to primary osteoarthritis (OA). Methods Data from the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) was analysed to determine cumulative percent revision rate (CPR), revision indication and functional outcome scores for THA performed for patients undergoing THA for Perthes disease and primary OA between 2003 and 2023. Results There were 1159 THAs for LCPD and 521,603 for primary OA available for analysis. Patients with LCPD incurred a higher CPR in the first two weeks postoperatively, but no difference was observed beyond this time. The CPR adjusted for age, head size, sex and femoral fixation for patients with LCPD at 18 years was 8.5% (95% CI 5.6,12.8) compared to 7.1% (95% CI 7.0, 7.3) for patients with primary OA. There was no difference in the reason for revision. Functional outcome scores were similar, although those patients with LCPD had slightly lower improvement in the Oxford Hip Score. Conclusion Revision rates following THA are comparable between patients with LCPD and primary OA at eighteen years post-operatively. The higher early revision rate in LCPD patients warrants further investigation into contributing factors including surgical planning, types of prostheses, and the influence of previous surgery.
Steiger et al. (Thu,) studied this question.