# OSTEOCHONDRITIS DISSECANS OF THE HIP IN LEGG-CALVÉ-PERTHES DISEASE: CASE REPORT AND REVIEW

## TL;DR

A 10-year-old boy with a hip condition following Legg-Calvé-Perthes disease successfully underwent surgery to fix a bone fragment, leading to improved hip function.

## Contribution

This case report highlights the successful use of surgical hip dislocation for treating osteochondritis dissecans following LCPD.

## Key findings

- Surgical hip dislocation enabled anatomical fixation of the OCD fragment and improved hip biomechanics.
- The patient showed excellent functional recovery one year after surgery.
- The approach allows assessment of hip stability and other hip-related issues.

## Abstract

Legg-Calvé-Perthes disease (LCPD) is the idiopathic osteonecrosis of the capital femoral epiphysis in children. It is a self-healing condition, and the morphology of the hip may vary according to the severity of the disease, among several other factors. The treatment focuses on attempts to prevent femoral head collapse, obtain functional hip motion recovery, and reduce pain. Osteochondritis Dissecans (OCD) of the femoral head has been reported in 2% to 7% of patients diagnosed with healed LCPD. Although OCD may remain asymptomatic, the osteochondral fragment has the potential to become unstable, evolving into symptoms of pain, locking, catching, and snapping.

We present a case report of a ten-year-old boy with an OCD lesion following LCPD who underwent effective osteochondral fixation through the surgical hip dislocation approach. The patient evolved to excellent functional recovery at 1 year post-operatively.

The surgical hip dislocation approach allows anatomical fixation of the OCD fragment, as well as improvement of hip biomechanics, decreasing pain, improving range of motion and joint congruency, and preserving the native articular cartilage. It also gives the surgeon the opportunity to assess hip stability, femoroacetabular impingement and labral tears, allowing a wide variety of options for the treatment of the healed LCPD.
Level of Evidence IV; Type of study Case Report.