THA Following Pediatric Hip Diseases (Legg-Calvé-Perthes/Slipped Capital Femoral Epiphysis)

  • Eustathios Kenanidis
  • Panagiotis Kakoulidis
  • Vasileios Lampridis
  • Michail E. Klontzas
  • Eleftherios Tsiridis
  • Jan F. A. Somers
  • Ran Schwarzkopf
  • Andrew Brian Old
  • Jens Vanbiervliet
  • Jean-Pierre Simon


Legg-Calvé-Perthes disease (LCPD) represents a type of idiopathic avascular necrosis of the femoral head which typically develops during childhood [1, 2]. Its etiology is considered to be multifactorial but is generally unknown; genetic, constitutional, and environmental factors have been implicated [3]. Despite receiving treatment, some patients initially develop morphological changes in the femoral head and secondarily acetabular deformity, femoroacetabular in congruency, and the abnormal hip movement that could lead to early-onset secondary osteoarthritis [1, 4]. In a current prospective cohort, 5% of LCPD patients underwent THA at 20 years after nonoperative treatment [5]. Stulberg classification is used as prognostic tool of hip osteoarthritis at skeletal maturity [2]; Stulberg types III–V are more susceptible to the development of early secondary hip osteoarthritis [1].


  1. 1.
    Al-Khateeb H, Kwok IH, Hanna SA, Sewell MD, Hashemi-Nejad A. Custom cementless THA in patients with Legg-Calvé-Perthes disease. J Arthroplast. 2014;29(4):792–6.CrossRefGoogle Scholar
  2. 2.
    Baghdadi YM, Larson AN, Stans AA, Mabry TM. Total hip arthroplasty for the sequelae of Legg-Calvé-Perthes disease. Clin Orthop Relat Res. 2013;471(9):2980–6.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Mazloumi SM, Ebrahimzadeh MH, Kachooei AR. Evolution in diagnosis and treatment of Legg-Calvé-Perthes disease. Arch Bone Joint Surg. 2014;2(2):86–92.PubMedGoogle Scholar
  4. 4.
    Larson AN, Sucato DJ, Herring JA, Adolfsen SE, Kelly DM, Martus JE, Lovejoy JF, Browne R, Delarocha A. A prospective multicenter study of Legg-Calvé-Perthes disease: functional and radiographic outcomes of nonoperative treatment at a mean follow-up of twenty years. J Bone Joint Surg Am. 2012;94:584–92.CrossRefPubMedGoogle Scholar
  5. 5.
    Traina F, De Fine M, Abati CN, Bordini B, Toni A. Outcomes of total hip replacement in patients with slipped capital femoral epiphysis. Arch Orthop Trauma Surg. 2012;132(8):1133–9.CrossRefPubMedGoogle Scholar
  6. 6.
    Schoof B, Citak M, O’Loughlin PF, Kendoff D, Haasper C, Gehrke T, Gebauer M. Eleven year results of total hip arthroplasty in patients with secondary osteoarthritis due to slipped capital femoral epiphysis. Open Orthop J. 2013;7:158–62.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Engesæter LB, Engesæter IØ, Fenstad AM, Havelin LI, Kärrholm J, Garellick G, Pedersen AB, Overgaard S. Low revision rate after total hip arthroplasty in patients with pediatric hip diseases. Acta Orthop. 2012;83(5):436–41.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Traina F, De Fine M, Sudanese A, Calderoni PP, Tassinari E, Toni A. Long-term results of total hip replacement in patients with Legg-Calvé-Perthes disease. J Bone Joint Surg Am. 2011;93(7):e25.CrossRefPubMedGoogle Scholar
  9. 9.
    Pietrzak K, Strzyzewski W, Pucher A, Kaczmarek W. Total hip replacement after Legg-Calvé-Perthes disease. Chir Narzadow Ruchu Ortop Pol. 2011;76(3):129–33.PubMedGoogle Scholar
  10. 10.
    Lehmann TG, Engesaeter IØ, Laborie LB, Lie SA, Rosendahl K, Engesaeter LB. Total hip arthroplasty in young adults, with focus on Perthes’ disease and slipped capital femoral epiphysis: follow-up of 540 subjects reported to the Norwegian Arthroplasty register during 1987–2007. Acta Orthop. 2012;83(2):159–64.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Thillemann TM, Pedersen AB, Johnsen SP, Søballe K. Danish hip Arthroplasty registry. Implant survival after primary total hip arthroplasty due to childhood hip disorders: results from the Danish hip Arthroplasty registry. Acta Orthop. 2008;79(6):769–76.CrossRefPubMedGoogle Scholar
  12. 12.
    Lim YW, Kim MJ, Lee YS, Kim YS. Total hip arthroplasty in patient with the sequelae of Legg-Calvé -Perthes disease. Hip Pelvis. 2014;26(4):214–9.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Larson AN, McIntosh AL, Trousdale RT, Lewallen DG. Avascular necrosis most common indication for hip arthroplasty in patients with slipped capital femoral epiphysis. J Pediatr Orthop. 2010;30(8):767–73.CrossRefPubMedGoogle Scholar
  14. 14.
    Boyle MJ, Frampton CM, Crawford HA. Early results of total hip arthroplasty in patients with slipped upper femoral epiphysis compared with patients with osteoarthritis. J Arthroplast. 2012;27(6):1003–7.CrossRefGoogle Scholar
  15. 15.
    Bedard NA, Callaghan JJ, Stefl MD, Liu SS. Systematic review of literature of cemented femoral components: what is the durability at minimum 20 years followup? Clin Orthop Relat Res. 2015;473(2):563–71.CrossRefPubMedGoogle Scholar
  16. 16.
    Costa CR, Johnson AJ, Naziri Q, Mont MA. Review of total hip resurfacing and total hip arthroplasty in young patients who had Legg-Calvé-Perthes disease. Orthop Clin North Am. 2011;42(3):419–22.CrossRefPubMedGoogle Scholar
  17. 17.
    Helms NJ, Lewallen LW, McIntosh AL, Sierra RJ. Total hip arthroplasty in the young: special emphasis on post-SCFE patients. J Pediatr Orthop. 2013;33(Suppl 1):S137–42.Google Scholar
  18. 18.
    Amstutz HC, Su EP, Le Duff MJ. Surface arthroplasty in young patients with hip arthritis secondary to childhood disorders. Orthop Clin North Am. 2005;36(2):223–30.CrossRefPubMedGoogle Scholar
  19. 19.
    Lewthwaite SC, Squires B, Gie GA, Timperley AJ, Ling RS. The Exeter Universal hip in patients 50 years or younger at 10-17 years’ followup. Clin Orthop Relat Res. 2008;466(2):324–31.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Sandiford NA, Duncan CP, Garbuz DS, Masri BA. Tapered, fluted titanium stems in revision total hip arthroplasty: role and results in contemporary practice. Instr Course Lect. 2015;64:359–66.PubMedGoogle Scholar
  21. 21.
    Hoberg M, Konrads C, Engelien J, Oschmann D, Holder M, Walcher M, Rudert M. Outcome of a modular tapered uncemented titanium femoral stem in revision hip arthroplasty. Int Orthop. 2015;39(9):1709–13.CrossRefPubMedGoogle Scholar
  22. 22.
    Le D, Smith K, Tanzer D, Tanzer M. Modular femoral sleeve and stem implant provides long-term total hip survivorship. Clin Orthop Relat Res. 2011;469(2):508–13.CrossRefPubMedGoogle Scholar
  23. 23.
    Somers JFA. Metal ion levels in ceramic-on-ceramic THR with modular necks. Hip Int. 2015;25(5):484–7.CrossRefPubMedGoogle Scholar
  24. 24.
    Ling RS, Charity J, Lee AJ, et al. The long-term results of the original Exeter polished cemented femoral component: a follow-up report. J Arthroplasty. 2009;24(4):511–7.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Eustathios Kenanidis
    • 1
  • Panagiotis Kakoulidis
    • 1
  • Vasileios Lampridis
    • 1
  • Michail E. Klontzas
    • 2
  • Eleftherios Tsiridis
    • 3
  • Jan F. A. Somers
    • 4
  • Ran Schwarzkopf
    • 5
  • Andrew Brian Old
    • 6
  • Jens Vanbiervliet
    • 7
  • Jean-Pierre Simon
    • 8
  1. 1.Academic Orthopaedic UnitAristotle University Medical SchoolThessalonikiGreece
  2. 2.Imperial College London, Biological Systems Engineering LabLondonUK
  3. 3.Academic Orthopaedic UnitPapageorgiou General Hospital, Aristotle University Medical SchoolThessalonikiGreece
  4. 4.Department of SurgeryYan Yperman HospitalYpresBelgium
  5. 5.Department of Orthopaedic SurgeryNYU Langone Health Orthopaedic Hospital, Hospital for Joint DiseasesNew YorkUSA
  6. 6.Premier OrthopaedicsPenn Medicine Chester County HospitalWest ChesterUSA
  7. 7.Yan Yperman HospitalYpresBelgium
  8. 8.University Hospitals LeuvenLeuvenBelgium

Personalised recommendations