Volume 9, Issue 4 (11-2022)
JROS 2022, 9(4): 219-224 |
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Pisoudeh K, Gravandi S. Clinical Results, Tonnis Classification, and Stulberg Classification in Patients With Legg-Calvé-Perthes Disease Underwent Containment Surgeries. JROS 2022; 9 (4) :219-224
URL: http://jros.iums.ac.ir/article-1-2223-en.html
URL: http://jros.iums.ac.ir/article-1-2223-en.html
1- Department of Orthopedics, Bone and Joint Reconstruction Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Abstract: (159 Views)
Background and Objectives: The treatment methods for Legg-Calvé-Perthes disease (LCPD) patients with Herring C involvement scores are divided into two categories: Non-surgical treatments, including pain relief and physical therapy, braces or casts; and surgical treatments, including all types of femoral head containment surgeries. Although many researchers agree with conservative treatment, some also declare that surgery can be effective in improving the clinical results of group C patients. This study’s goals include examining clinical results, osteoarthritis status based on Tonnis classification, and Stulberg deformity degree of patients with LCPD with Herring C involvement scores, who underwent various types of containment surgery.
Methods: In this study, 18 patients (19 hips) diagnosed as Herring group C involvement LCPD underwent one type of containment surgery, including femoral varus osteotomy, femoral valgus osteotomy, Salter osteotomy, Ganz osteotomy, and triple innominate osteotomy. Participants who met the inclusion criteria were examined in terms of demographic-biometric information (age, follow-up period, gender, operated side, body mass index) and clinical-radiographic information, including range of motion, lower limb discrepancy (LLD), limping, Trendelenberg test, tenderness, classification of osteoarthritis based on Tonnis classification, Merle d’Aubigne-Postel score, and Stulberg classification.
Results: The mean patients’ current age and age at surgery were 13.9±3.3 and 8.3±2 years, respectively, and the mean follow-up period was 5.7±2.8 years. Two hips belonged to one female patient (10.5%), and 18 hips belonged to 18 male patients (89.5%). The left side was more frequently involved (57.9%), and the mean body mass index was 21.3 kg/m2. In the post-operation clinical results examination, significant differences were observed in only 3 variables: Range of motion in abduction (P<0.001), external rotation (P=0.042), and extension (P=0.037). Tonnis osteoarthritis class also improved significantly after surgery (P=0.029). The mean post-op Merle score of patients was 17.3. Regarding post-op Stulberg class, the highest frequency was related to class 2 with 42.1% (8 people) and no patient was placed in class 5.
Conclusion: In addition to improving the range of motion, surgery reduces Tonnis osteoarthritis classification and Stulberg grade in LCPD Herring C patients.
Methods: In this study, 18 patients (19 hips) diagnosed as Herring group C involvement LCPD underwent one type of containment surgery, including femoral varus osteotomy, femoral valgus osteotomy, Salter osteotomy, Ganz osteotomy, and triple innominate osteotomy. Participants who met the inclusion criteria were examined in terms of demographic-biometric information (age, follow-up period, gender, operated side, body mass index) and clinical-radiographic information, including range of motion, lower limb discrepancy (LLD), limping, Trendelenberg test, tenderness, classification of osteoarthritis based on Tonnis classification, Merle d’Aubigne-Postel score, and Stulberg classification.
Results: The mean patients’ current age and age at surgery were 13.9±3.3 and 8.3±2 years, respectively, and the mean follow-up period was 5.7±2.8 years. Two hips belonged to one female patient (10.5%), and 18 hips belonged to 18 male patients (89.5%). The left side was more frequently involved (57.9%), and the mean body mass index was 21.3 kg/m2. In the post-operation clinical results examination, significant differences were observed in only 3 variables: Range of motion in abduction (P<0.001), external rotation (P=0.042), and extension (P=0.037). Tonnis osteoarthritis class also improved significantly after surgery (P=0.029). The mean post-op Merle score of patients was 17.3. Regarding post-op Stulberg class, the highest frequency was related to class 2 with 42.1% (8 people) and no patient was placed in class 5.
Conclusion: In addition to improving the range of motion, surgery reduces Tonnis osteoarthritis classification and Stulberg grade in LCPD Herring C patients.
Keywords: Legg–Calvé–Perthes disease (LCPD), Classification of Herring, Containment surgery, Stulberg’s classification
Type of Study: Research Article |
Subject:
Hip surgery
Received: 2022/02/17 | Accepted: 2022/03/12 | Published: 2022/11/1
Received: 2022/02/17 | Accepted: 2022/03/12 | Published: 2022/11/1
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