Trial reportThe bone & joint journal2022
The British Orthopaedic Surgery Surveillance study: Perthes' disease: the epidemiology and two-year outcomes from a prospective cohort in Great Britain.
Trial report in The bone & joint journal, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
11 citing papers in PubMed.
- Nationwide Epidemiological and Demographic Evolution of Legg-Calvé-Perthes Disease: A 10-Year Analysis.Journal of the Pediatric Orthopaedic Society of North America · 2026Article
- [Legg-Calvé-Perthes disease in early childhood: conservative versus surgical management : A risk-adapted containment approach].Orthopadie (Heidelberg, Germany) · 2026Review
- Article
- Treatment for primary avascular necrosis of the lower limb in childhood.The Cochrane database of systematic reviews · 2026Article
- Testing the usability and acceptability of the NON-STOP app for children with Perthes' disease.Bone & joint open · 2026Article
- Biochanin A enhances type H vessel formation and improves epiphysis deformities following ischemic osteonecrosis in juvenile mouse.Frontiers in nutrition · 2025Article
- Article
- Demographics and risk for containment surgery in patients with unilateral Legg-Calvé-Perthes disease: a national population-based cohort study of 309 patients from the Swedish Pediatric Orthopedic Quality Register.Acta orthopaedica · 2024Observational
- Epidemiology, natural evolution, pathogenesis, clinical spectrum, and management of Legg-Calvé-Perthes.Journal of children's orthopaedics · 2023Review
- Inhibition of Toll-Like Receptor 4 Signaling Pathway Accelerates the Repair of Avascular Necrosis of Femoral Epiphysis through Regulating Macrophage Polarization in Perthes Disease.Tissue engineering and regenerative medicine · 2023Article
- The management of developmental dysplasia of the hip in children aged under three months : a consensus study from the British Society for Children's Orthopaedic Surgery.The bone & joint journal · 2023Article
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsThe aim of this study was to evaluate the epidemiology and treatment of Perthes' disease of the hip.
methodsThis was an anonymized comprehensive cohort study of Perthes' disease, with a nested consented cohort. A total of 143 of 144 hospitals treating children's hip disease in the UK participated over an 18-month period. Cases were cross-checked using a secondary independent reporting network of trainee surgeons to minimize those missing. Clinician-reported outcomes were collected until two years. Patient-reported outcome measures (PROMs) were collected for a subset of participants.
resultsOverall, 371 children (396 hips) were newly affected by Perthes' disease arising from 63 hospitals, with a median of two patients (interquartile range 1.0 to 5.5) per hospital. The annual incidence was 2.48 patients (95% confidence interval (CI) 2.20 to 2.76) per 100,000 zero- to 14-year-olds. Of these, 117 hips (36.4%) were treated surgically. There was considerable variation in the treatment strategy, and an optimized decision tree identified joint stiffness and age above eight years as the key determinants for containment surgery. A total of 348 hips (88.5%) had outcomes to two years, of which 227 were in the late reossification stage for which a hip shape outcome (Stulberg grade) was assigned. The independent predictors of a poorer radiological outcome were female sex (odds ratio (OR) 2.27 (95% CI 1.19 to 4.35)), age above six years (OR 2.62 (95% CI (1.30 to 5.28)), and over 50% radiological collapse at inclusion (OR 2.19 (95% CI 0.99 to 4.83)). Surgery had no effect on radiological outcomes (OR 1.03 (95% CI 0.55 to 1.96)). PROMs indicated the marked effect of the disease on the child, which persisted at two years.
conclusionDespite the frequency of containment surgery, we found no evidence of improved outcomes. There appears to be a sufficient case volume and community equipoise among surgeons to embark on a randomized clinical trial to definitively investigate the effectiveness of containment surgery. Cite this article:
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