Treatment methods

Perthes' disease therapy: conservative options

Regular physiotherapy, often over several years, is an important element of the treatment of Perthes' disease. This is the only way in which to keep the femoral head centred in the acetabular cup and to therefore significantly improve the mobility of the hip.

If this mobility cannot be adequately improved through physiotherapy, there are other conservative options:

• Extension therapy - With this treatment, a weight is used to stretch the muscles around the hip joint, relieving the strain on the joint
• Petrie cast - This is sometimes required especially before planned operations to improve mobility
  

Generally speaking, the patient is able to weight-bear in everyday situations, but bearing in mind the following motto: walk as little as possible in order to avoid over-exerting the hip joint.

If the hip joint has poor mobility, however, the child is limping or there is an effusion of the joint, walking aids or a wheelchair may be needed to relieve the hip joint.

Sport, including trampolining and hopping, is banned throughout the course of the disease until the bone has fully reformed. Only swimming and cycling are permitted, in moderation.

Perthes' disease therapy: surgical options

When the femoral head is no longer fully enclosed by the acetabular cup, this is known as loss of containment. In such cases, often only surgical measures will help to re-centre the femoral head back in the cup. This can take the form of a procedure on the thigh bone (varisation osteotomy) or the pelvis (pelvic osteotomy).  In some cases, the combination of both surgical treatments is required.