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Legg-Calvé-Perthes disease: role of isolated adductor tenotomy?

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Abstract

Background

The aim of the study was to compare the radiological results at maturity of patients with Legg-Calve-Perthes disease, treated either by a uniform conservative treatment or by an adductor longus tenotomy.

Methods

The study cohort comprised 349 hips, mean age 4.4 years. Patients were classified in two different groups depending on the treatment performed. The conservative group (Group I) consisted of 318 hips that had been treated by physical therapy and abduction cast/brace, with a mean age 4.3 years (range 1–10). The tenotomy group (Group II) consisted of 31 hips (treated conservatively but developed an adduction contracture limited to 30°), which had been treated by adductor longus tenotomy with a mean age of 6.2 years (range 2–9). Hip range of motion and radiographic studies were performed at the time of admission. The extent of femoral epiphyseal involvement was assessed at each follow-up by the method of Herring. The final outcomes were assessed at skeletal maturity according to the Stulberg classification system.

Results

Only one patient (two hips) from Group II experienced an improvement in abduction, which was maintained throughout the follow-up until complete the healing of Legg-Calvé-Perthes disease was achieved. In the remaining 29 hips, we observed a progressive loss of ROM previous to 4.3 months from the tenotomy. According to the Stulberg classification, we did not find differences between both groups at final follow-up (p > 0.05).

Conclusions

These preliminary data suggest that the isolated tenotomy of the adductor longus tendon does not modify the natural evolution of Legg-Calvé-Perthes disease.

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Conflict of interest

The authors report that they have no conflict of interest.

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Authors and Affiliations

  1. Hospital Fremap (Majadahonda), Carretera de Pozuelo 61, Majadahonda, 28220, Madrid, Spain

    Joaquín Moya-Angeler

  2. Hospital Universitario Niño Jesus, Madrid, Spain

    Juan Carlos Abril

  3. Hospital Ruber Internacional, Madrid, Spain

    Juan Carlos Abril

  4. Hospital Virgen del Puerto de Plasencia, Plasencia, Spain

    Ignacio Varo Rodriguez

Authors
  1. Joaquín Moya-Angeler
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  2. Juan Carlos Abril
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  3. Ignacio Varo Rodriguez
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Corresponding author

Correspondence to Joaquín Moya-Angeler.

Additional information

The study was conducted in Hospital Universitario Niño Jesus, Madrid, Spain.

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Moya-Angeler, J., Abril, J.C. & Rodriguez, I.V. Legg-Calvé-Perthes disease: role of isolated adductor tenotomy?. Eur J Orthop Surg Traumatol 23, 921–925 (2013). https://doi.org/10.1007/s00590-012-1116-7

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  • DOI: https://doi.org/10.1007/s00590-012-1116-7

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