Functional Outcomes of Soft Tissue Release Surgery in Advanced Legg-Calve-Perthes Disease

Abstract

Objectives: This study aimed to investigate the functional and radiological outcomes in Legg–Calvé–Perthes Disease (LCPD) patients undergoing soft tissue release surgery. Materials and methods: Ten children (11 hips) diagnosed with LCPD who had previously been conservatively treated with movement limitation were included in the study. Patients in the late fragmentation period of the disease were evaluated with arthrography in hip-neutral, abduction, abduction/internal rotation, and adduction positions using radioscopy. Dynamic examination using arthrography was performed to determine whether the patient had any bone pathologies (hinging). For patients with no bone pathology, adductor longus and iliopsoas tenotomy and inferior capsulotomy were performed. Sitting was allowed immediately following surgery, and mobilization with support was allowed after the wound had healed. Patients were followed up at regular intervals. Functional assessments of patients were made using the Harris hip scoring system. Evaluation of radiological imaging was carried out according to the Stulberg classification. Results: The mean age of patients was 10.9 (6–15) years. According to the Herring lateral pillar classification, one patient was type B, three were type B/C, and seven were Type C. At the 12-month follow-up, the active range of motion was increased, and hip pain decreased. At the final follow-up (patients followed for 1–5 years; mean: 3 years), one patient was evaluated as type II, seven as type IV, and three as type V according to the Stulberg classification. The mean Harris hip score was 92.3. Conclusion: Soft tissue release surgery performed as tenotomy in LCPD patients had no effect in terms of radiological characterization, but had positive functional impacts.