Biologic Osteotomy in Perthes Disease

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Abstract
This is a study to demonstrate the biologic effect of a proximal femoral osteotomy in Perthes disease. Fifty-two hips in 49 patients treated with prolonged recumbency in a Robert Jones abduction frame were reviewed. Twenty-six of these hips had, in addition, a proximal femoral osteotomy. No significant relation between the treatment group and Mose rating (p > 0.05), epiphyseal quotient (p > 0.05), or healing rate (p > 0.05) was found. In the group of patients with Catterall III and IV disease, there were 44% good, 29% fair, and 29% poor results. Based on this study, the biologic aspect of the osteotomy probably does not influence the radiologic outcome or the healing rate in Perthes disease; hence, the beneficial effects of a containment osteotomy probably occur as a result of mechanical rather than biologic means.

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