Perthes Disease

What is Perthes Disease?

Perthes Disease, also known as Legg-Calvé-Perthes Disease, is a condition that affects the hip joint, and shows primarily in children between the ages of 4 and 10. It occurs when there is a temporary loss of blood supply to the femoral head (the "ball" of the hip joint), leading to changes in the hip joint and causing hip pain and mobility problems. Exercises can play a significant role in maintaining hip function and reducing discomfort.

The exact cause of Perthes Disease is not fully understood, but it is believed to be related to reduced blood flow to the femoral head. Genetic and environmental factors may also play a role. It is not contagious and cannot be prevented.

How is Perthes Disease diagnosed?

Perthes progresses through three main phases, each of which can take a variable amount of time:

Sclerosis → Fragmentation → Remodelling → Healed

At the end point of Perthes Disease, the prognosis of the hip determines on the final shape of both the femur (ball) and the acetabulum (socket). Sometimes it is hard to determine the final state of the hip from the early stages and that is why multiple review and imaging is needed as progression through the phases occurs, so that early if intervention is needed it can be acted on early.

The common signs and symptoms of Perthes Disease include:

Hip pain
Limp
Limited range of motion or stiffness

Diagnosis of Perthes Disease typically involves detailed examination. Imaging such as x-rays, CT scans and MRI scans may be needed to evaluate the level of involvement of the hip. Diagnosis can sometime require multiple reviews and x-rays at different points in time to confirm the early diagnosis.

How is Perthes Disease treated?

Coping with Perthes Disease can be challenging for both the child as well as the family. It is important to have the right team to collaborate on managing the condition and work towards a common goal, including the patient, family, medical specialists, and allied health professionals. Most crucially, understanding the importance of maintaining range of motion with regular follow up is a large contributor to your child’s outcomes.

Dr Eardley-Harris has been extensively trained and has experience in both diagnosis, and treatment of Perthes Disease including operative and non-operative interventions, and will discuss specific details, unique to the patient in his consultation. It is normal for Dr Eardley-Harris to continue to follow up a hip diagnosed with Perthes Disease well into adulthood to be able to intervene when appropriate. Dr Eardley-Harris also has extensive experience in treating the long-term complications of Perthes Disease including hip realignment surgery, or even hip replacement at a young age (young adult or adolescent).

As the condition progresses, treatment options include:

Observation: Especially during the early stages of the disease.
Rest and Activity Modification: Reducing physical activity and avoiding high-impact activities can help protect the hip joint while it heals. This includes sport, jumping, trampolines and rough play
Physiotherapy: Physiotherapy exercises can help maintain range of motion and strengthen the muscles around the hip joint. This may include hydrotherapy.
Bracing: A brace or cast may be recommended to keep the hip in a stable position during the healing process.
Surgery: Surgery may be necessary to reshape the femoral head, realign the hip joint, lengthen tight tendons or even perform hip replacement.

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Note: The information on this page is for educational purposes only and should not replace consultation with a qualified healthcare provider. Always seek professional medical advice for you, and your child's specific condition.

Meet Nathan

Adult & Paediatric Hip and Knee Surgeon

Dr Nathan Eardley-Harris has experience in providing care for patients throughout the entire spectrum of life

As an Australian-trained Orthopaedic Surgeon based in Adelaide, South Australia specialising in hip and knee surgery covering very young children to the elderly and everyone in-between, Nathan offers personalised care to help patients find the best outcomes in every unique condition.

He has subspecialty, post-fellowship training in hip preservation surgery and joint replacement, including robotic & technology-assisted surgery across all approaches, including the direct anterior approach. Through compassion, communication, collaboration & competence, Nathan aims to build patient-surgeon trust, helping you understand your condition and the options available to empower you to make better treatment decisions toward your personal recovery goals. With stronger, better-informed patient-surgeon relationships, evidence-based surgical techniques and the latest assistive technology, Nathan aims to provide patients with the best possible care.

My Approach

Personalised Care

Your condition, goals and challenges are unique to you, and your management should reflect that. There is no one-size-fits-all method for treatment - your care is tailored to your situation.

Evidence-based, Modern Technology

With the latest technology including robotics and 3D personalised planning to support evidence-proven surgical techniques, you get accurate, precise results. If surgery is necessary, it’s customised to your situation.

Collaboration With Professionals

See the right team of elite health professionals, hand-selected to provide you with the best outcomes given your condition, rehabilitation & goals.

Comprehensive Surgical Care

Decision for Surgery

Together we have made the decision that surgery is the best pathway forward. Our team will discuss with you the timing and the location of your surgery, including the expected length of stay in hospital.

Personalised Surgical Planning

Dr Eardley-Harris will sit down and plan your specific surgery to best achieve your goals. This may involve further tests needed for the planning, as well as any unique circumstances to your condition or injury.

Preparation

Prior to surgery, you will be given specific instructions to be ready for the operation. This may include certain tests, medication management, and pre-surgery & aftercare information.

Day of Surgery

On the day of surgery, Dr Eardley-Harris will visit you in the pre-operative room, and answer any other questions that you have, and ensure that you are ready for your procedure. During your surgery, our team will ensure you are comfortable and well-informed.

Recovery

Following surgery you will enter the recovery room, with specialised nursing care. Here, you and your family will be informed of the findings, allowing you to be confident in the outcome. You will follow your pre-planned aftercare procedures to allow your body to recover.

Questions

Choosing surgery is a significant decision that often involves careful consideration of various factors. If you have any questions throughout your process, feel free to ask Dr Eardley-Harris' team for further clarity.

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