Background Legg-Calvé-Perthes disease (LCPD) is a common public health problem that usually occurs between the ages of 4 and 8 years, but it can occur between the ages of 2 and 15 years. This condition occurs due to the interruption of blood supply to the femoral head. Up to now, different surgical and nonsurgical treatments, including femoral varus osteotomy, innominate osteotomy, pelvic osteotomies, triple osteotomy, Chiari osteotomy, and shelf acetabuloplasty, have been suggested for noncontainable LCPD hips. Objective The aim of this comprehensive review was to investigate the various surgical techniques used for LCPD. Methods An advanced electronic search of the English-language literature was performed from October 8 to 14, 2020. The electronic databases PubMed, MEDLINE, Web of Science, Embase, Ovid, and Google scholar were searched using appropriate search terms. A manual search of references also was performed. After retrieving the studies, duplicates were removed, and the remining studies were screened based on the title, abstract, and full text. The quality of the selected articles was assessed, and the required data were extracted from eligible articles. Results A total of 22 studies were included in the review. Based on the results of the reviewed studies, there are three main factors that influence the treatment outcomes in patients with Perthes disease. These factors are onset age, femoral head involvement severity, and treatment method. The disease has a poor prognosis in children over 8 years old, but this group of patients can also benefit from advanced surgical methods. In patients aged less than 6 years, the disease has a generally good prognosis, but in those aged between 6 and 8 years, its prognosis is variable. Thus, the need for surgical intervention requires close observation of signs. Once any head signs are observed, dynamic arthrography is beneficial before choosing the treatment approach. Conclusions This review provides clinicians with a brief guideline for the treatment of patients with LCPD.

Background Coronal alignment after total knee arthroplasty (TKA) would influence the implant survival. Coronal alignment could be measured on short and full-length X-rays. The goal of the current study was to assess the correlation of short and full-length X-rays to accurate prediction of the true Hip-Knee-Ankle alignment after TKA in the Iranian population. Methods Lateral distal femoral and medial proximal tibial angles, FTA, HKA, in 180 Iranian patients (243 knees without extra-articular deformities) were measured and compared on short and full-length standing X-rays of primary TKA pre/postoperatively. Results The correlation between the preoperative FTA-short and FTA-long, FTA-short and HKA, and FTA-long and HKA values in degrees were fair, good and good (r = 0.64) (r = 0.73), (r = 0.76), respectively. This correlation for postoperative aMPTA and mMPTA (r = 0.73), and FTA-short and HKA (r = 0.76) values were good and significant (P = 0.001). Also, assessing coronal alignment based on short and full-length measurements would result in varying pre/postoperative alignments (varus, neutral and valgus). Conclusion Full length X-rays could not be replaced by short knee X-rays to asses true coronal alignment in TKA; considerable portion of our cases were missorted as varus, neutral or valgus based on the FTA versus the HKA. Intraoperative fixed 5° valgus angle cut of distal femur did not result in postoperative favorable neutral alignment in all cases. Level of evidence IV.

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BACKGROUND Legg-Calvé-Perthes disease (LCPD) is a common public health problem that usually occurs between the ages of 4 and 8 years, but it can occur between the ages of 2 and 15 years. This condition occurs due to the interruption of blood supply to the femoral head. Up to now, different surgical and nonsurgical treatments, including femoral varus osteotomy, innominate osteotomy, pelvic osteotomies, triple osteotomy, Chiari osteotomy, and shelf acetabuloplasty, have been suggested for noncontainable LCPD hips. OBJECTIVE The aim of this comprehensive review was to investigate the various surgical techniques used for LCPD. METHODS An advanced electronic search of the English-language literature was performed from October 8 to 14, 2020. The electronic databases PubMed, MEDLINE, Web of Science, Embase, Ovid, and Google scholar were searched using appropriate search terms. A manual search of references also was performed. After retrieving the studies, duplicates were removed, and the remining studies were screened based on the title, abstract, and full text. The quality of the selected articles was assessed, and the required data were extracted from eligible articles. RESULTS A total of 22 studies were included in the review. Based on the results of the reviewed studies, there are three main factors that influence the treatment outcomes in patients with Perthes disease. These factors are onset age, femoral head involvement severity, and treatment method. The disease has a poor prognosis in children over 8 years old, but this group of patients can also benefit from advanced surgical methods. In patients aged less than 6 years, the disease has a generally good prognosis, but in those aged between 6 and 8 years, its prognosis is variable. Thus, the need for surgical intervention requires close observation of signs. Once any head signs are observed, dynamic arthrography is beneficial before choosing the treatment approach. CONCLUSIONS This review provides clinicians with a brief guideline for the treatment of patients with LCPD.