Legg Calve Perthes Disease in Children

  • We've had the 100th anniversary year of the first recognition of Legg-Calve-Perthes disease. Dr. Arthur Legg, who in 1910 was one of the first describers of the condition, was a Boston Children's orthopedic surgeon. So, we have a long history and vast experience treating children with this condition.

    –Young-Jo Kim, MD, PhD, orthopedic surgeon, Boston Children's Hospital

    If your child has been diagnosed with Legg-Calvé-Perthes disease, you probably have many concerns and questions about his health, treatment, recovery and other issues. It may comfort you to know that Children’s Hospital Boston is a world leader in pediatric orthopedics and we have a wealth of experience helping children with this rare condition. We specialize in innovative, family-centered care that supports your child and family every step of the way.

    About Legg-Calvé-Perthes disease

    • Legg-Calvé-Perthes disease (also called LCP or Perthes disease) is a temporary hip condition in which the ball-shaped head of the thigh bone (femoral head) loses its blood supply (avascular necrosis). As a result, the head of the thigh bone collapses, and the area becomes inflamed and irritated.
    • Legg-Calvé-Perthes disease causes the hip joint to become painful and stiff for a period of time that varies from child to child. Your child may limp, with or without pain.
    • Affected children are usually:
      • between 4 and 10 years old
      • very physically active
      • small for their age
    • During the course of the condition, in the acute phase which can last two years or longer, the body absorbs the dead bone cells and replaces them with new bone cells. The new bone cells eventually reshape the head of the thigh bone (femur), but the result can be a deformation that can cause arthritis later on.
    • If signs and symptoms develop late (when the child is more than 6 years old), the condition is likely to be more serious, with a greater chance of a deformed joint that’s vulnerable to premature arthritis.
    • Proper non-surgical or surgical treatment during the course of the disease helps to alleviate your child's pain and make sure his hip retains its normal shape and range of motion.
    • Early diagnosis and treatment of severe cases help to avert the worst effects of arthritis.
    • The majority of cases affect one hip; 10 to 12 percent of cases affect both hips, but not usually at the same time.
    • The condition is rare—affecting about one in every 12,000 children.

    How Boston Children's Hospital approaches Legg-Calvé-Perthes disease and other developmental hip conditions

    Boston Children's orthopedic surgeon Arthur Thornton Legg, MD, one of the doctors after whom the condition is named, first recognized and described Legg-Calvé-Perthes disease in 1910. Since then, Children’s surgeons have built up a vast body of knowledge of, and experience with, Legg-Calvé-Perthes disease; we’ve pioneered advanced techniques for re-shaping the femoral head and optimizing joint function and longevity.

    Today, an important aspect of treating Legg-Calvé-Perthes disease is diagnosing the condition early in childhood. Early diagnosis and treatment allow as much time as possible for the head of your child's thigh bone to remodel itself back into a round shape, since children’s softer bones heal quickly and have a good capacity for self-repair. Treatment goals include controlling pain, maintaining hip motion and preventing additional hip deformity.

    Other developmental hip conditions


    Whatever hip treatment your child requires, you can have peace of mind knowing that, as national and international orthopedics referral centers, Boston Children’s Orthopedic Center and Child and Young Adult Hip Preservation Program have deep experience treating children with every kind of hip condition, some of which few other pediatric hospitals have ever encountered. As a result, we can provide expert diagnosis, treatment and care for every level of complexity and severity of hip problem.

    Unique expertise in treating adolescents with hip problems

    Many adolescents and young adults with hip problems need diagnostic and surgical techniques that differ significantly from what’s indicated for younger children. Boston Children’s Child and Young Adult Hip Preservation Program is the only such program of its kind. We offer the extensive experience and the most advanced techniques, with clinicians and researchers who are dedicated to finding better ways to care for adolescents and young adults with hip problems.

    Leaders in Bernese periacetabular osteotomy (Bernese PAO)


    At Boston Children's, we’ve performed more than 1,400 Bernese PAOs since 1991 to correct hip dysplasia in teens and adults. Our large volume makes us the most experienced center in the United States for this procedure—and the second-most experienced in the world. The Bernese PAO—the most powerful procedure for repositioning the hip socket—is Children’s standard treatment for a hip socket that’s too shallow in a patient whose socket has finished growing (typically children ages 13 and older).

    One of the first programs

    Our Orthopedic Center is one of the world’s first comprehensive pediatric orthopedic programs, and today is the largest pediatric orthopedic surgery center in the United States, performing more 6,000 procedures each year. Our program, consistently ranked among the top in the country by U.S.News & World Report, is the nation’s preeminent care center for children and young adults with developmental, congenital, post-traumatic and neuromuscular problems of the musculoskeletal system.

    Legg-Calvé-Perthes disease: Reviewed by Young-Jo Kim, MD, PhD
    © Boston Children's Hospital, 2011

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