Long-Term Results of Total Hip Replacement in Patients with Legg-Calvé-Perthes Disease

Background: Total hip replacement in patients with Legg-Calvé-Perthes disease can be difficult because of the multi-planar deformities of the proximal part of the femur and previous surgery during childhood. The aim of the present study was to assess the long-term outcomes of total hip replacement in patients who had Legg-Calvé-Perthes disease during childhood. Methods: A retrospective study was carried out to assess the results of thirty-two total hip replacements that had been performed for twenty-seven patients from January 1989 to November 2004. The average age at the time of surgery was 37.8 years. The average duration of follow-up was 124 months (range, fifty-eight to 248 months). All but one of the implants were cementless. Results: There was only one failure in the present study; specifically, the one cemented stem in the study failed two years after surgery. The cumulative survival rate at fifteen years was 96.9 % (95 % confidence interval, 90.8 % to 100.0%). The overall rate of complications was 12.5%, with two permanent sciatic nerve palsies. At the time of the latest follow-up, the average Harris hip score was 87.5 (range, 73 to 96), which was a marked improvement in comparison with the preop-erative score (average, 50.1; range, 25 to 75). Conclusions: Despite the high rate of neurological complications, possibly related to excessive limb lengthening or inadequate soft-tissue release, total hip replacement can be considered a feasible option for patients with Legg-Calvé