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Perthes Disease Treatment Pune
Get expert Perthes disease treatment in Pune with pediatric hip specialists providing joint preservation and mobility-focused rehabilitation.
Overview
Legg-Calvé-Perthes Disease (LCPD) is a childhood hip condition that affects the ball-shaped top of the thighbone (femoral head). When blood flow to this area is temporarily interrupted, the bone tissue begins to die—a process called avascular necrosis. This condition primarily strikes children between ages 4 and 10, causing the femoral head to weaken and potentially collapse if left untreated.
The disease unfolds over several years as the body naturally tries to heal itself. During this process, the femoral head may become deformed, leading to long-term hip problems. However, with proper medical care and early intervention, most children can achieve excellent outcomes and maintain normal hip function throughout their lives.
Symptoms
Parents often notice the first signs of LCPD when their child begins favoring one leg or walking differently. The symptoms typically develop gradually and may include:
- Limping, especially after physical activity or by the end of the day
- Hip pain that may be felt in the groin, thigh, or surprisingly, the knee
- Stiffness in the hip joint, particularly after rest periods
- Reduced range of motion when moving the hip in different directions
- Muscle weakness or wasting around the thigh area
- Difficulty with activities like running, jumping, or climbing stairs
It’s important to note that children may complain of knee pain rather than hip pain, which can sometimes delay proper diagnosis. Any persistent limping or leg pain in a child should be evaluated by a healthcare professional.
Causes
The exact cause of LCPD remains unclear, but researchers believe it results from a temporary interruption of blood supply to the femoral head. Several factors may contribute to this blood flow disruption:
- Vascular problems: Temporary blockage or damage to the small blood vessels that nourish the femoral head
- Minor trauma: Small injuries that may trigger or reveal the underlying condition
- Blood clotting disorders: Conditions that increase the tendency for blood to clot abnormally
- Genetic factors: Some families show patterns suggesting a hereditary component
- Environmental influences: Exposure to secondhand smoke has been linked to increased risk
Risk Factors
While any child can develop LCPD, certain factors increase the likelihood:
- Age: Most commonly affects children between 4-10 years old
- Family history: Having relatives with LCPD may increase risk
- Tobacco smoke exposure: Children exposed to secondhand smoke face greater risk
- Birth factors: Low birth weight and delayed bone development may contribute
Diagnosis
Diagnosing LCPD requires a combination of physical examination and imaging studies. Healthcare providers will:
Physical Examination:
- Assess the child’s walking pattern and gait
- Test hip range of motion and flexibility
- Check for pain and tenderness around the hip joint
- Examine leg length and muscle strength
Imaging Tests:
- X-rays: The primary diagnostic tool showing bone changes, fragmentation, and collapse
- MRI scans: More sensitive in early stages, detecting bone swelling and blood flow changes before X-ray abnormalities appear
- Bone scans: Occasionally used to evaluate blood supply to the femoral head
Early diagnosis is crucial because prompt treatment can prevent severe deformity and preserve hip function.
Stages
| Stage | Description |
|---|---|
| Initial (Necrosis) | Blood supply is interrupted; bone death begins. |
| Fragmentation | Dead bone is resorbed and replaced; femoral head weakens and fragments. |
| Reossification | New bone formation begins; the femoral head starts to heal. |
| Healed | Bone remodeling completes; femoral head shape stabilizes. |
Treatment
Treatment aims to maintain the spherical shape of the femoral head and prevent collapse. The approach depends on the child’s age, disease stage, and severity of involvement.
Non-Surgical Treatment:
- Activity modification: Limiting high-impact activities while encouraging gentle movement
- Physical therapy: Maintaining hip flexibility and strengthening surrounding muscles
- Pain management: Over-the-counter medications to control discomfort
- Bracing or casting: Keeping the femoral head properly positioned in the hip socket
Surgical Options:
- Osteotomy: Realigning the thighbone or pelvis to improve hip mechanics
- Femoral or pelvic surgery: For severe cases or older children with significant deformity
- Joint distraction: Specialized techniques to promote healing in select cases
Rehabilitation
Rehabilitation plays a vital role in recovery and typically involves:
- Range of motion exercises to maintain hip flexibility
- Strengthening programs targeting hip and thigh muscles
- Gait training to improve walking patterns
- Activity progression gradually returning to normal activities
- Long-term monitoring to track hip development and function
The rehabilitation process may extend from months to years, depending on disease severity and treatment response.
Complications
Without proper treatment, LCPD can lead to serious long-term problems:
- Permanent deformity of the femoral head
- Early arthritis due to abnormal joint mechanics
- Chronic pain and limited mobility
- Leg length differences between affected and unaffected sides
- Hip stiffness and muscle weakness
Early intervention significantly reduces the risk of these complications and improves long-term outcomes.
Prevention
Since the exact cause of LCPD is unknown, there’s no guaranteed way to prevent it. However, parents can:
- Avoid tobacco smoke exposure in children
- Seek prompt medical attention for persistent limping or leg pain
- Maintain overall health through proper nutrition and regular healthcare
- Follow up regularly with healthcare providers if risk factors are present
Living With Legg-Calvé-Perthes Disease
While an LCPD diagnosis can be overwhelming, most children adapt well with proper support:
- Regular follow-up appointments with orthopedic specialists
- Adherence to treatment plans and activity restrictions
- Monitoring for complications or changes in symptoms
Key Takeaways
- Legg-Calvé-Perthes Disease is a childhood hip condition caused by temporary loss of blood supply to the femoral head, leading to bone death and potential deformity
- The condition primarily affects children aged 4-10 years, with boys being more commonly affected than girls
- Early symptoms include limping, hip or knee pain, and reduced hip mobility that require prompt medical evaluation
- Diagnosis involves physical examination and imaging studies, with X-rays and MRI being the primary diagnostic tools
- Treatment focuses on preserving femoral head shape through activity modification, physical therapy, bracing, or surgery depending on severity
- Rehabilitation and long-term monitoring are essential components of successful treatment
- With early diagnosis and appropriate care, most children achieve excellent outcomes and maintain normal hip function
- At Sancheti Hospital, our specialized pediatric orthopedic team provides comprehensive care for children with LCPD, offering advanced diagnostic capabilities, personalized treatment plans, and expert rehabilitation services to ensure the best possible outcomes for young patients
Meet Our Pediatric Orthopedic Specialists
Patient Stories & Experiences
The pain in my left knee left me feeling helpless for years. After my treatment here, I can finally say I'm pain-free.
Vinita Singh
The nerves were swollen, and the body went numb. But thanks to Sancheti Hospital, I got a second life!
Parvati
I finally could walk again, a relief I've only felt after the hip pain surgery. I thank the doctors at Sancheti Hospital for their help.
Balaji Kharat
I'm a police officer, and I'm extremely thankful to Sancheti Hospital for treating my fracture without surgery.
Shantilal
My life has completely changed after the knee replacement surgery at Sancheti Hospital. It's like I can finally live again!
Kalpana Lepcha
The knee pain I've carried for years finally went away with the help of Sancheti Hospital.
Karuna
I can't believe that I get to finally live a normal and happy life, all thanks to the knee surgery I had at Sancheti Hospital.
Kishore Bhosle
Frequently Asked Questions
Can Legg-Calvé-Perthes Disease be cured?
While there’s no instant “cure,” the condition can be effectively managed with proper treatment to prevent permanent damage and maintain hip function.
Is the condition hereditary?
Although genetic factors may play a role, LCPD is not directly inherited. Environmental and vascular factors are equally important.
How long does treatment take?
Treatment duration varies from several months to years, depending on the child’s age, disease severity, and response to treatment.
Will my child develop arthritis later?
If the femoral head heals with significant deformity, there’s increased risk of early arthritis. Proper treatment greatly reduces this risk.
Can adults get this condition?
No, LCPD is exclusively a childhood condition. However, untreated cases can cause adult hip problems.
