Short-term radiographic outcome of varus osteotomy in the treatment of Legg-Calve-Perthes disease: a retrospective case series study

Background: Varus osteotomy is a popular method for the operative treatment of Legg-Calve-Perthes disease (LCPD). In this study, the authors aimed to evaluate the radiographic outcomes of varus osteotomy and its association with the extent of hip involvement. Methods: Twenty-one patients in early stages of disease (stage I and II of LCPD, according to the modified Elizabethtown classification) who were treated with varus osteotomy were studied. The radiographic outcome measures were Caput Index and epiphyseal quotient (EQ) that were assessed before the surgery and 2 yr postoperatively. The level of hip involvement was determined by the modified lateral pillar classification. Results: The mean Caput index of the patients improved from 55.5 +/- 12.7 to 74 +/- 13.4 (P<0.001). The mean EQ of the patients improved from 47.2 +/- 12.9% to 67.8 +/- 17.1% (P<0.001). According to the EQs, the radiographic outcomes were found to be good, fair, and poor in 16 (76.1%) patients, 4 (19.1%) patients, and 1 (4.8%) patient, respectively. The mean change of Caput Index and EQ was significantly more in the B/C lateral pillar group than C lateral pillar group (P=0.04 and P=0.02, respectively). Conclusions: Varus osteotomy could be recommended as an effective surgical treatment for LCPD. The level of hip involvement at presentation could be used as independent factors of surgical prognosis.