Hip Arthroscopy in Perthes' Disease: A Systematic Review of Literature and Meta-analysis

Abstract

egg calve perthes disease is idiopathic avascular necrosis of growing head of femur. perthes disease has different racial and demographic variations with family history in 5-6% of patients. Perthes disease causes many mechanical symptoms as hip pain with limitation of hip range of motion mainly hip abduction and internal rotation. This condition causes femoral head deformity with incongurency with acetabulum with resultant sublaxation of head of femur from acetabulum, this results in poor development of the acetabulum resulting in shallow acetabulum and resultant hip dysplasia. Perthes disease also may cause labral tears and osteochondritis dissicans resulting from loose bodies in hip. This may terminally end in degenerative hip changes resulting in hip osteoarthritis. Severity of perthes disease and its prognosis varies according to different stages of disease with lateral pillar classification of perthes being most important. Treatment of perthes disease is highly challenging with different modalities are present depending on age of patient and severity of the disease. Treatment includes conservative treatment in casting, femoral or acetabular osteotomies or combined or correction of resulting deformity by hip preserving surgeries. These modalities are very effective showing great results but have several complications as blood loss, non-union of osteotomy site.