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Topic:

Legg-Calve-Perthes Disease

Issue:

Hip

Category:

Developmental

Title:

Adherence to Wide-Abduction Brace Treatment is Associated With Improved Hip Abduction and Radiographic Outcomes in Legg-Calvé-Perthes Disease

Author:

Prasadh, Jai Ganesh BS; Kang, Michael Seungcheol MD, PhD; Shah, Hitesh MBBS, MS Orth; Jo, Chan-Hee PhD; Kim, Harry K.W. MD

Journal:

Journal of Pediatric Orthopaedics

Date:

November/December 2024

Reference:

44(10): p 592-600, DOI: 10.1097/BPO.0000000000002787

Level Of Evidence:

III

# of Patients:

57

Study Type:

Retrospective study

Location:

Not specified (single-center likely)

Summary:

This study investigates the effect of adherence to A-frame brace treatment in children with Legg-Calvé-Perthes disease (LCPD). The results suggest that higher adherence to brace use is associated with improved hip abduction range of motion, decreased femoral head deformity, and better radiographic outcomes.

Methods:

Retrospective analysis of patients aged 4 to 11 years with LCPD treated with an A-frame brace. Brace adherence was measured using built-in temperature sensors. Hip abduction and radiographic outcomes (Deformity Index and Sphericity Deviation Score) were assessed at the 2-year follow-up. Pearson correlation and regression analysis were performed.

Exclusions:

Patients over 11 years old or those treated with osteotomy before completing brace treatment were excluded.

Results:

Adherence to the brace was positively correlated with increased hip abduction (R=0.36, P=0.006) and decreased deformity index (R=-0.37, P=0.042). Increased adherence also led to decreased sphericity deviation score (R=-0.58, P=0.024) in patients under 9 years old at the time of treatment. A +0.50 increase in adherence was associated with a +9.4° increase in hip abduction and improvements in radiographic scores.

Conclusions:

Greater adherence to A-frame brace treatment in children with LCPD results in better hip abduction, reduced femoral head deformity, and improved sphericity. This study supports counseling patients and parents on the importance of brace adherence to maximize treatment outcomes.

Relevance:

Limitations:

Perspective:

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