Body Mass Index (BMI) in Legg-Calve-Perthes Disease / 대한정형외과학회잡지

PURPOSE: To describe the relationship between BMI (body mass index: weight in kilograms/height in meter(2)) and final Stulberg outcome in LCP disease. MATERIALS AND METHODS: The data of a total of 255 unilaterally involved patients (bone age> or =6 years, average age at induction: 7.8 years) were studied. The non-surgical treatment group involved; a) no treatment (20), b) brace (83), c) range of motion (ROM) exercise (62), while surgical treatment included either a) femoral osteotomy (38), or b) Salter innominate osteotomy (52). Treatment result was as follows: Stulberg I (20), II (88), III (96), IV (49), V (2). RESULTS: 1) A weak correlation was founded between BMI and Stulberg outcomes in the whole study group (Spearman correlation 0.11; p=0.078). The mean BMI of the Stulberg IV&V (poor) groups was significantly greater than that of those in the Stulberg I&II (good) and III (fair) group (p=0.011). 2) BMI was related to Stulberg outcome in the brace and range of motion groups (Spearman correlation 0.17; p=0.045). The mean BMI of the Stulberg IV&V group was significantly greater than that of Stulberg I&II group in the brace & ROM groups (p=0.017). However, these statistical significances were not found in the surgery and no-treatment groups. CONCLUSION: BMI may play a role in the Stulberg outcome. A higher BMI is associated with a poorer outcome, especially in patients treated by brace or ROM.

Effect of a Limited Range of Motion of the Hip Joint on Final Outcome in LCP Disease / 대한정형외과학회잡지

PURPOSE: We studied the effect of a limited range of motion (ROM) of the hip joint on the final outcome in LCP disease. MATERIALS AND METHODS: ROM data obtained during the initial 3 years after diagnosis in unilaterally involved 325 pillar B or C hips (bone age> or =6 years, average age at induction: 7.9 years) were studied. The non-surgical treatment group included: a) no treatment (23), b) brace (113), and c) ROM exercise (70). The surgical treatment group included: a) femoral osteotomy (49), and b) Salter innominate osteotomy (70). We assessed the relationship between the limited ROM and the Stulberg outcome. RESULTS: In the non-surgical treatment group, those patients who had never experienced limited motion below 110degrees or 100degrees of flexion, below 20degrees or 10degrees of abduction, and below 10degrees of adduction, were significantly associated with a good Stulberg outcome (p<0.05). Using these reduced ROM parameters in combination, as a single factor, outcome prediction was possible in 44% of cases. No correlation was found in surgically treated patients. CONCLUSION: Our results support that ROM is an important prognostic factor in the non-surgical treatment group. Surgical procedures seem to change the biomechanical status of the hip joint in Perthes disease, thereby affecting the ralationship between ROM and Stulberg outcome.