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- Talk
- 21/09/2021
- UK
Leg Length Difference in Legg-Calvé-Perthes Disease; Changes in Femoral Morphology and the Role of Contralateral Epiphysiodesis
Description
The transcript presents a detailed discussion led by Deborah Eastwood regarding the implications of leg length differences in patients suffering from Perthes disease. Beginning with a personal touch, she expresses gratitude for the adjusted program schedule due to unforeseen circumstances. She introduces the topic, mentioning Aresh's long-standing concerns about the role of leg length discrepancies in Perthes patients, emphasizing a significant number of patients experience a measurable difference in leg length, often linked to femoral head involvement.
Eastwood outlines the study’s goals, which focus on understanding the morphological changes in femurs affected by Perthes disease and how these changes contribute to leg length discrepancies. She discusses the methodology of a retrospective cohort study conducted on patients treated at the Royal National Orthopaedic Hospital, specifying the criteria for inclusion and exclusion.
The presentation touches on patient demographics and the common treatments received, notably valgus and varus osteotomies. A significant part of the analysis centers around measuring total leg length along with femoral and tibial lengths, and the findings reveal that discrepancies predominantly arise from issues above the greater trochanter.
In a compelling narrative, Eastwood discusses the consequences of corrective surgery, including contralateral epiphysiodesis, which can superficially equalize leg lengths but may lead to complications that affect hip replacements later in life. She emphasizes the importance of careful pre-operative assessments and the need for ongoing communication with patients about their leg length and potential future procedures.
The dialogue transitions into a Q&A where audience members engage with Eastwood, probing further into specifics about osteotomy types and the treatment approach. Eastwood asserts that while some patients may require tibial procedures, it is essential to balance leg length correction with maintaining optimal femoral morphology to ensure successful surgical outcomes in the future. Throughout the talk, her expertise and attention to patient-centered care are evident, culminating in an acknowledgment of the complexity of managing Perthes disease.