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Trochanteric advancement in patients with Legg-Calvé-Perthes disease does not improve pain or limp

 Sun Young Joo  ;  Ki Seok Lee  ;  Il Hyun Koh  ;  Hui Wan Park  ;  Hyun Woo Kim 
 Clinical Orthopaedics and Related Research, Vol.466(4) : 927-934, 2008 
Journal Title
 Clinical Orthopaedics and Related Research 
Issue Date
Adolescent ; Adult ; Biomechanical Phenomena ; Femur/diagnostic imaging ; Femur/growth & development ; Femur/surgery* ; Follow-Up Studies ; Gait* ; Hip/diagnostic imaging ; Hip/physiopathology* ; Humans ; Legg-Calve-Perthes Disease/complications ; Legg-Calve-Perthes Disease/diagnostic imaging ; Legg-Calve-Perthes Disease/physiopathology ; Legg-Calve-Perthes Disease/surgery* ; Osteotomy* ; Pain/diagnostic imaging ; Pain/etiology* ; Pain/physiopathology ; Pain/surgery ; Pain Measurement ; Pelvic Bones/diagnostic imaging ; Pelvic Bones/physiopathology* ; Radiography ; Range of Motion, Articular ; Recovery of Function ; Retrospective Studies ; Time Factors ; Treatment Outcome
Femoral Head ; Great Trochanter ; Abductor Muscle ; Perthes Disease ; Instrument Gait Analysis
Premature closure of the proximal epiphysis in patients with Legg-Calvé-Perthes disease can cause overgrowth of the greater trochanter. We asked whether distal transfer of the greater trochanter relieved pain and improved limp and whether the operation changed frontal plane kinematic and kinetic parameters of the hip and pelvis in the gait analysis. We reviewed 15 patients (15 hips) with an average age of 16.9 years (range, 13-26 years) who had the operation and were followed for a minimum of 28 months (average, 42 months; range, 28-54 months). The Iowa hip score increased from 85.0 (range, 75.5-87.0) before surgery to 89.1 (range, 83.0-97.0) at the final followup. Only three patients had no pain and Trendelenburg sign postoperatively. Pelvic obliquity angle of affected and contralateral normal hips in ipsilateral stance and contralateral swing phases remained unchanged after surgery. Hip adduction angle and abductor moment during single stance phase of affected and contralateral normal hips were not changed. We concluded trochanteric advancement does little to relieve pain and improve limp in patients with relative overgrowth of the greater trochanter and Legg-Calvé-Perthes disease. LEVEL OF EVIDENCE: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence
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1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Hyun Woo(김현우) ORCID logo https://orcid.org/0000-0001-8576-1877
Park, Hui Wan(박희완)
Lee, Ki Seok(이기석)
Joo, Sun Young(주선영)
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