Legg-Calve-Perthes Disease

Your child’s activity levels will be limited if it’s suspected they have Perthes disease or if they’re diagnosed with the condition. It’s important to minimize their discomfort and allow the bone to regrow properly. This may include bed rest, a wheelchair, non-weight-bearing, gently moving the legs with weights, and the use of a walker or crutches while your child’s bones heal.

Medication for Perthes disease aims to minimize your child’s pain by decreasing the inflammation of their joint(s).

Your child may be prescribed nonsteroidal anti-inflammatory drugs, or NSAIDs, including ibuprofen and naproxen. Your doctor will explain the dosing schedule to you, and it may change as your child's condition is treated.

Physical therapy is often the first treatment for children with mild symptoms of Perthes disease and typically begins shortly after diagnosis. It helps restore hip joint range of motion, reduce pain and inflammation, and protect the joint during healing.

A physical therapy program may include exercises to:

• Improve hip range of motion
• Strengthen muscles in the pelvis and legs
• Address balance and walking difficulties
• Prevent stiffness in muscles and joints

Sometimes, healthcare providers may recommend using a removable Petrie cast to keep the ball of the hip joint positioned correctly in the socket while it heals in very young people. This rigid, fiberglass cast covers both legs from the hips to the ankles and has a bar connecting the legs to keep them spread apart in the shape of the letter “A.” The cast can be removed temporarily for physical therapy.

Your child will usually wear the cast full-time for up to six months. Afterward, it is typically worn only at night.

Surgery is sometimes recommended for children with Perthes disease who are older or have a significant deformity. Two common procedures used to treat Perthes disease include:

• Osteotomy: Your child’s femur or pelvic bone is cut to fit securely within the hip socket, repositioning the bone correctly so it can regrow in the right place. Plates and screws secure the area as it heals. These are removed once treatment is complete.
• Hip arthroscopy: This less invasive procedure may be used to treat complications related to Perthes disease, such as hip impingement. In arthroscopy, a surgeon inserts a camera and small surgical instruments through tiny incisions.