“To treat or not to treat?” has remained the central question ever since Perthes’ disease was first described 70 years ago. Which is the best treatment and to whom it should be applied, remains the next important question for all except therapeutic nihilists. As the disease is relatively uncommon, most reports are on few patients and have generally struck a favourable note. In 1 960 a special c...

BACKGROUND Long-term studies have indicated good outcomes for most patients with Legg-Calvé-Perthes disease. However, clinical experience suggests that less favorable outcomes are common. We sought to prospectively document pain and function in a cohort of adults who had previously been treated nonoperatively for Legg-Calvé-Perthes disease. METHODS Patients in our region with Legg-Calvé-Perth...

AIMS To determine the incidence and distribution of Legg-Calvé-Perthes' disease in Liverpool, in the period 1982-95. METHODS Examination of information in a register, analysing the patients' addresses by indices of deprivation. RESULTS A total of 122 white children were diagnosed as having Perthes' disease during the study, whereas black and minority groups form 5.8% of the population. The ...

We reviewed the radiographs of 49 patients with Perthes' disease at the stage of fragmentation and also after the end of skeletal growth to assess the value of the lateral pillar classification of Herring. The average age of the patients at diagnosis was 7 years 6 months and the mean follow-up was 24 years. Ten of the 11 Herring group-A hips showed good reconstruction of the femoral head. There...

We performed superselective angiography in 28 hips in 25 patients with Perthes' disease in order to study the blood supply of the lateral epiphyseal arteries (LEAs). Interruption of the LEAs at their origin was observed in 19 hips (68%). Revascularisation in the form of numerous small arteries was seen in ten out of 11 hips in the initial stage of Perthes' disease, in seven of eight in the frag...

Since 1975, none of our patients with Perthes' disease have received any active treatment, except for managing severe pain. We have studied the functional and radiological results in order to evaluate the consequences of this approach and to demonstrate the natural history of the disease. We have followed up all patients over the age of 19 years; out of 20 only 6 were free of pain and only 2 re...

Thirty-four patients were studied throughout the evolution of Perthes' disease. The acetabular changes included osteopoenia of the roof, irregularity of its contour, and decrease in its depth. These changes were proportional to the femoral head involvement. The purpose of the study was to assess the effect of the morphological changes of the femoral head on the acetabulum and the outcome, and t...