Variation in the treatment of Perthes disease can certainly be confusing if not maddening to parents seeking answers.Unfortunately it seems like we still have more questions than answers regarding this disease. Be that as it may, the question: “Why are there such varied treatments of Perthes disease among doctors?” is an immensely valid one.

Treatment variation can come from several sources. One is the disease itself. Perthes does not affect every child in exactly the same way, so treatment must be tailored to the needs of the individual child. Another source of variation is individual training and experience of the pediatric orthopaedic surgeon. Not all doctors receive exactly the same teaching and training.

At some point in the future biological treatments and specialized medications may allow us to treat Perthes at its earliest stages.Until then we are simply reacting to relatively established Perthes. The treatment principles are well known and nearly universally accepted: containment and range-of-motion. Containment means doing the best job we can keeping the femoral head in the socket and range-of-motion means optimizing the movement of the hip (both achieved either surgically or non-surgically).

Learn more from publications on Perthes:



Balasa VV, Gruppo RA, Glueck CJ, Wang P, Roy DR, Wall EJ, Mehlman CT, Crawford AH. Legg-Calve-Perthes disease and thrombophilia. J Bone Joint Surg-Am 2004;86:2642-2647.



Bowen JR, Guille JT, Jeong C, Worananarat P, Oh CW, Rodriguez A, Holmes L, Rogers KJ. Labral support shelf arthroplasty for containment in early stages of Legg-Calve-Perthes disease. J Pediatr Orthop 2011 (2 Suppl);31:S206-S211.    


Nguyen NT, Klein G, Doghey G, McCourt JB, Mehlman CT. Operative versus nonoperative treatment for Legg-Calve-Perthes disease: a meta-analysis. J Pediatr Orthop 2012;32:697-705.