Clinical Outcomes of Total Hip Arthroplasty in Patients with
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Complications and patient reported outcomes (PROs) of total hip arthroplasty (THA) in patients with Legg-Calve Perthes disease (LCPD) have demonstrated variable results. The purpose of this study was to use a validated grading scheme to analyze complications associated with THA in patients with residual LCPD deformities. Secondly, PROs and intermediate-term survivorship in this patient population are also reported.

A retrospective, single-center review was performed on 61 hips in 61 patients who underwent THA for residual Perthes disease. Average patient age was 42 years and 26% of hips had previous surgery. Complications were determined and categorized using a validated grading scheme that included five grades based on the treatment required to manage the complication and on persistent disability. PROs were compared from preoperative to most recent follow-up time points.

--Major complications (grade III) occurred in three patients (5%) which each required a second surgical intervention.

--The most common minor grade-I or II complications (11.5%) were asymptomatic heterotopic ossification (3.3%).

--Patients were lengthened on the surgical side an average of 1.4 cm with no nerve palsies.

--All patient PROs improved from preoperative to postoperative time points with the modified Harris Hip Score improving from 46.9 preoperatively to 85.4 postoperatively.

--Patients free from revision for any reason at final follow-up (5.6 years; range 2-13 years) was 98.4% with one patient needing a revision of their femoral component.

Conclusively, Total hip arthroplasty for the sequelae of the Legg-Calve Perthes disease has an acceptable complication rate and provides excellent patient reported outcomes at mid-term follow-up.