Perthes Disease
Perthes Disease occurs in children where too little blood is supplied to the upper ball portion of the femoral head, also known as the hip joint.
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What is Perthes Disease?
Perthes Disease, or Legg Calve Perthes Disease, is a condition that affects the hip joint in children. It occurs when the blood supply to the head of the femur (thigh bone) is disrupted.
Without an adequate supply of blood, the bone begins to soften and deteriorate, leading to a loss of its normal shape and function. This loss of shape can lead to pain, stiffness and loss of mobility in the affected hip joint.
Treatment for Perthes Disease
Perthes disease is a condition that can be effectively managed with the right treatment approach. The recovery process takes time, typically between 2 and 5 years, as the femoral head gradually heals. During this period, the bone is soft and needs careful protection.
The aim of treatment is to support the healing process, help reduce any discomfort, and ensure the femoral head remains as round and stable as possible. Dr Gary Nattrass works closely with families to develop a personalised treatment plan tailored to your child’s specific needs.
Treatment options for Perthes Disease
Conservative Treatment
In many cases, a non-invasive approach can be highly effective. This may include limiting high-impact activities, encouraging rest, and using a brace or cast to help protect the hip while it heals. These methods help reduce strain on the femoral head and allow the bone to regenerate safely.
Physiotherapy
Once the initial pain and inflammation have been managed, physiotherapy plays a key role in maintaining and improving joint mobility. Targeted exercises can strengthen the muscles around the hip, improve range of motion and support overall hip function during recovery. Dr Gary will guide you on the appropriate exercises based on your child’s condition and progress.
Managing pain effectively is an important part of treatment. Pain relief may involve medication or other methods tailored to your child’s needs, ensuring they remain comfortable during their recovery process.
Surgery
In some cases, surgical intervention may be necessary, particularly if there is significant damage to the femoral head or if non-invasive treatments are not effective. Surgical procedures such as femoral osteotomy may be recommended to realign the hip and encourage more normal bone development. Dr Gary will discuss the potential benefits and risks of surgery with you, ensuring the best possible outcome for your child.
Symptoms
Common symptoms of Perthes disease include:
Limping: A child with Perthes disease often develops a limp, especially after walking, running or playing. This is usually due to pain or weakness in the affected hip.
Limited Range of Motion: The affected hip joint may become stiff, making it difficult to move the leg in certain directions. This can include limited ability to bend the knee or rotate the hip.
Hip Pain: Often the first noticeable symptom, typically affecting the hip, thigh or groin. The pain may worsen with activity and improve with rest.
Muscle Weakness: Over time, the muscles around the hip joint may become weaker due to reduced use of the hip, which can contribute to difficulty with walking or running.
Leg length discrepancy: Shortening of the affected leg, leading to uneven leg length.
Perthes Disease Diagnosis
Perthes Disease Diagnosis
As a paediatric orthopaedic specialist, Dr Gary has extensive experience in treating Perthes disease and is dedicated to creating a personalised treatment plan that offers your child the best chance for a full and successful recovery. If you suspect your child may have Perthes disease, Dr Gary will conduct a thorough clinical examination, review their medical history and use advanced imaging techniques to help form an accurate diagnosis.
Your one-on-one consultation will also give you the opportunity to ask any questions you may have about Perthes disease, its diagnosis, and the treatment options available.
Quick Facts About Perthes Disease
Cause
Trauma/Infection/Hereditary
Signs/ Symptoms
Thigh, groin or knee pain, limping, reduced range of motion
Treatment
Physiotherapy, medication, surgery
Treatment Process
Easy/Moderate
Recovery
Surgery 12 months
Covered under Medicare?
Yes, select patients may be eligible
Download Perthes Disease Fact Sheet
For more information, download the Royal Children’s Hospital Melbourne Perthes Disease Fact Sheet.
Perthes Disease FAQ
Though we do not fully understand the exact cause of Perthes Disease, a disruption in the blood supply to the head of the femur occurs which leads to the death of bone tissue. This results in a loss of the normal hip anatomy and function. Usually there is no known cause, but common contributing factors include
- Trauma via direct injury to the hip
- Blood flow issues
- Infection
- Other disease processes
Perthes Disease affects approximately 1 in 10 000 children. It is more common in males than females and typically occurs in children between 4 and 8 years old.
The most common Perthes Disease symptom is a pain in the hip, thigh, groin or knee. However, it can present as a painless limp.
If your child is diagnosed with Perthes Disease treatment can include
- Rest and limiting weight on the affected hip (crutches or a wheelchair)
- Physiotherapy
- Pain and inflammation medications
- Surgery
The recovery time after surgery for Perthes Disease can vary depending on the condition severity and type of surgery performed. Whilst it can take 2-5 years for the hip to heal fully, it is extremely variable.
If left untreated, Perthes Disease can lead to several health complications including
- Persistent pain and arthritis in the hip joint
- Stiffness and limited range of motion in the hip joint
- Deformity in the hip joint
Speak to our friendly team
Not all conditions and symptoms are alike. If you have a concern about your child’s wellbeing or would like to direct questions to Gary Nattrass you may contact our friendly team on 03 9322 3360.
We will gladly take your call and assist you with your enquiry.