Evaluation of Function after Proximal Femoral Varus Osteotomy for Perthes Disease (Avascular Necrosis of the Proximal Femoral Head)

Background: Among the various methods of containment, femoral osteotomy is being widely used. The results are yet to be completely understood.

Material and Method: 20 Cases of Perthes disease underwent femoral osteotomy in between 2011-2014. 10 Cases which were conservatively treated were used as control. All cases were grade 2, 3, 4 (Caterall) hip with "head at risk". Follow up done at regular intervals for an average of 2 years. Hips that were not containable and were grade 1 Caterall lesion were excluded from study. Assessment - Clinically by Harris Hip Score(HHS). Radiologically by - 1) C.E. Angel of Weiberg, 2) Moss template. 3) Epiphyseal quotient.

Results: Clinically HHS was 88.74 (mean) for operative group and 69.7 (mean) for conservative group. Limb shortening on average was 1.5 cm. In the Radiologically operative group 75% had good or excellent result. In conservative group 30% had poor result.

Conclusion: Containment in form of femoral osteotomy definitely offers better results than conservative group. Limb shortening that follows osteotomy was not significant until concomitant femoral capital epiphyseal arrest.