PERTHES ’ DISEASE A Study of Thirty-four Hips Observed for Thirty Years

In 1953 I reviewed fifty cases of Perthes ’ disease from childhood to adult life. The follow-up was eleven to thirty years (Ratliff 1956). This paper reports the present state of the patients. Attention is given to possible clinical and radiological deterioration in the last twelve years. REVIEW OF THIRTY-FOUR AFFECTED HIPS The material for this study is based on thirty-four hips observed for an average of thirty years. The shortest period of follow-up was twenty-five years and the longest forty years. Most of the patients studied had been treated at the Biddulph Grange Orthopaedic Hospital, a few at the Robert Jones and Agnes Hunt Orthopaedic Hospital and the Princess Margaret Rose Hospital, Edinburgh. In all cases details oftreatment and radiographs in childhood were available and the patients were seen and radiographed both in early adult life in 1953 and again in 1965. Every endeavour was made to trace all the patients seen in 1953, but for various reasons this was not possible. Most patients were seen by me but in a few cases I am grateful to colleagues for examining these patients and reporting their present state. Twenty-five of the hips had been treated by immobilisation on frames; one had been immobilised in a hip spica. I have not attempted to differentiate between the result of these methods. The average period of immobilisation was eighteen months (shortest six months, longest twenty-four months). Eight patients received no treatment during the active phase of the disease, though a few of these received some treatment too late, when the femoral head was partly re-formed. These are classified together as “ untreated “ cases