PERTHES
DISEASE

Overview

Perthes disease is a hip disorder commonly seen in children characterized by a disruption of blood flow to the head of the femur (thigh bone).

Causes

Perthes disease is a rare childhood condition affecting 1 in every 9000 children. The disease occurs when the blood supply to the femoral head, or ball part of the hip joint, is cut off temporarily causing the bone to die. An inadequate amount of blood supply to the bone cells is what causes the bone to begin to die and stop growing. The long term prognosis for a child with Perthes’ disease, in a majority of cases, is good especially for those who are diagnosed early and who receive treatment.

Symptoms

An early sign of Perthes disease is a change in the way a child runs or walks. A child with this disease will experience a limp, stiffness, range of motion restrictions, pain in areas like the groin, knee, ankle or thigh, and atrophy in the affected legs thigh muscles. These symptoms can continue on and off for months. If you notice any of the symptoms in your child, having a doctor do an exam and x-rays is recommended.

Treatment

Even though about 60% of children with Perthes disease get better without treatment, it is very important to have follow up exams and x-rays to monitor the disease. Treatment of the disease is based on the severity of the disease and the age of the child. The main goals of treatment are to restore normal movement of the hip bone, preserve the shape of the femoral head, and relieve any pain. There are different ways to treat Perthes’ disease. Treatment options include non-surgical and surgical methods.

Non surgical treatment includes: 

• anti-inflammatory medications 

• physical therapy 

• bracing or casting 

• use of crutches, walker or wheelchair 

• bed rest 

• activity restrictions 

A doctor may recommend surgical treatment for a child who is older than age 8 at the time of the diagnosis. Because potential for deformity during the reossification stage increases for older children it becomes even more critical to prevent damage to the femoral head. Surgery may also be needed if more than 50% of the femoral head is damaged. Surgery is also recommended if the hip was not kept in the correct position for healing by non-surgical treatment.

Long-term effects of Perthes disease depends on how much the shape of the hip joint was altered by the disease. Some patients can end up with arthritis in their adult life. This could eventually lead to the adult needing hip replacement surgery. Unfortunately additional operations in childhood may be required if symptoms of stiffness and pain continue for years. These symptoms can continue even if the disease is no longer active. Luckily more than half of children with Perthes’ disease return to their normal active lives within a few years from the beginning of the disease. 

Please contact us to learn more about Perthes disease. We are here to assist you to alleviate your anxiety, fear, or reservations.