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Comparison of Outcomes of Salter and Varus Osteotomies in the Treatment of Legg-Calve-Perthes Disease: A Retrospective Cohort Study Publisher Pubmed



Mirghaderi P1, 6 ; Pahlevanfallahy MT1 ; Kargarsoleimanabad S2 ; Sharifi Razavi D3 ; Moharrami A4 ; Baghdadi T4 ; Mortazavi SMJ4, 5
Authors
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Authors Affiliations
  1. 1. Surgical research society (SRS), Students’ Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Student Research Committee, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
  3. 3. Student Research Committee, Semnan University of Medical Sciences, Semnan, Iran
  4. 4. Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. Adult Joint Reconstruction fellowship, Joint Reconstruction Research Center, Imam Khomeini Hospital, Tehran, Iran
  6. 6. Department of Radiology, Division of Musculoskeletal and Intervention, University of Washington, Seattle, WA, United States

Source: BMC Musculoskeletal Disorders Published:2025


Abstract

Background: Legg-Calve-Perthes Disease (LCPD) is described as idiopathic avascular osteonecrosis of the capital femoral epiphysis in pediatrics. LCPD is usually present in children between 2 and 15 years and happens more frequently in boys more than girls; this study aims to compare the outcome of two surgical methods in treating LCPD. Methods: We included sixty patients with unilateral LCPD who underwent Salter or femoral varus osteotomy from 2007 to 2017. Patients were followed up for at least five years. Patients’ claudication, pain, leg circumference, range of motion, lever arm ratio (LAR), neck shaft angle (NSA), migration index, vertical distance, and the presence of teardrop sign, sagging rope sign, and Trendelenburg sign were evaluated five years after surgery. Results: The mean neck shaft angle, the lever arm ratio, migration index and, sagging rope sign incidence in patients undergoing femoral varus osteotomy were significantly lower than those undergoing Salter surgery; the thigh circumference was higher in patients undergoing femoral varus osteotomy than those undergoing Salter osteotomy. Conclusion: There were significant differences in biomechanical indices of hip and acetabulofemoral in salter and femoral varus osteotomy; the results of the current study are highly suggestive of prioritizing femoral varus osteotomy to Salter surgery. © The Author(s) 2024.