Total hip arthroplasty after Legg–Calvé–Perthes disease

Background Patients who have hip osteoarthritis secondary to Legg–Calvé–Perthes disease (LCPD) have deformities of the acetabulum and femoral head; few studies have presented the outcome and risks associated with total hip arthroplasty (THA) for patients with a history of LCPD. Aim The aim of this study was to evaluate the results and complications associated with THA for LCPD. Patients and methods Thirty-four patients with secondary hip osteoarthritis as a sequelae of LCPD underwent cementless THA. Their average age was 38.7 years old (range: 26–65 years old), while the average follow-up period was 6.5 years (range: 5–10 years). The patients were evaluated clinically (using the Harris hip score) and radiologically. Results The Harris hip score improved from 48.2 points preoperatively to 92.8 points at the time of the last follow-up. The shortening of the affected limb has improved from −1.6 to 0.2 cm. The complications included three cases of intraoperative femur fractures and three cases of sciatic nerve palsy that developed after extensive lengthening of the lower limb. Patients with a history of previous childhood hip surgery were significantly younger at the time of arthroplasty when compared with patients who were treated nonoperatively (P=0.0006). Conclusion Hip arthroplasty showed good outcomes in patients with LCPD at an average of 6 years follow-up. Intraoperative fractures and nerve injuries are common. Caution should be taken while restoring leg length as stretching the sciatic nerve may result in a permanent deficit.