Table of Contents
ISRN Orthopedics
Volume 2011 (2011), Article ID 504393, 14 pages
http://dx.doi.org/10.5402/2011/504393
Review Article

The Epidemiology and Demographics of Legg-Calvé-Perthes' Disease

1Section of Orthopedic Surgery, Riley Hospital for Children, ROC 4250, 705 Riley Hospital Drive, IN, Indianapolis 46202, USA
2Department of Orthopaedic Surgery, Indiana University, Indianapolis, IN 46202, USA
3Ruth Lilly Medical Library, School of Medicine, Indiana University, Indianapolis, IN 46202, USA

Received 15 May 2011; Accepted 20 June 2011

Academic Editor: S. García-Mata

Copyright © 2011 Randall T. Loder and Elaine N. Skopelja. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Linked References

  1. A. Catterall, “The natural history of Perthes' disease,” Journal of Bone and Joint Surgery. British, vol. 53, no. 1, pp. 37–53, 1971. View at Google Scholar · View at Scopus
  2. R. B. Salter and G. H. Thompson, “Legg-Calve-Perthes disease. The prognostic significance of the subchondral fracture and a two-group classification of the femoral head involvement,” Journal of Bone and Joint Surgery. American, vol. 66, no. 4, pp. 479–489, 1984. View at Google Scholar · View at Scopus
  3. J. A. Herring, J. B. Neustadt, J. J. Williams, J. S. Early, and R. H. Browne, “The lateral pillar classification of Legg-Calve-Perthes disease,” Journal of Pediatric Orthopaedics, vol. 12, no. 2, pp. 143–150, 1992. View at Google Scholar · View at Scopus
  4. A. B. Nevelos, “Perthes' disease: the family tree,” Clinical Orthopaedics and Related Research, vol. 209, pp. 13–22, 1986. View at Google Scholar · View at Scopus
  5. B. Joseph, V. Chacko, B. S. Rao, and A. J. Hall, “The epidemiology of Perthes' disease in south India,” International Journal of Epidemiology, vol. 17, no. 3, pp. 603–607, 1988. View at Google Scholar
  6. N. A. Purry, “The incidence of Perthes' disease in three population groups in the Eastern Cape region of South Africa,” Journal of Bone and Joint Surgery. British, vol. 64, no. 3, pp. 286–288, 1982. View at Google Scholar
  7. W. C. Kim, K. Hiroshima, and T. Imaeda, “Multicenter study for Legg-Calvé-Perthes disease in Japan,” Journal of Orthopaedic Science, vol. 11, no. 4, pp. 333–341, 2006. View at Publisher · View at Google Scholar · View at PubMed
  8. W. W. Ebong, “Legg Calve Perthes disease in Nigerians,” International Surgery, vol. 62, no. 4, pp. 217–218, 1977. View at Google Scholar
  9. S. M. Rowe, S. T. Jung, K. B. Lee, B. H. Bae, S. Y. Cheon, and K. D. Kang, “The incidence of Perthes' disease in Korea. A focus on differences among races,” Journal of Bone and Joint Surgery. British, vol. 87, no. 12, pp. 1666–1668, 2005. View at Publisher · View at Google Scholar · View at PubMed
  10. C. Wijesekera, “Perthes' disease in Kurunegala,” The Ceylon Medical Journal, vol. 29, no. 2, pp. 65–83, 1984. View at Google Scholar
  11. A. G. Thompson and J. C. Y. Leong, “Legg-Calve-Perthes' disease in Southern Chinese children,” Journal of the Western Pacific Orthopaedic Association, vol. 15, no. 1, pp. 63–70, 1978. View at Google Scholar
  12. I. M. Gray, R. B. Lowry, and D. H. Renwick, “Incidence and genetics of Legg-Perthes disease (osteochondritis deformans) in British Columbia: evidence of polygenic determination,” Journal of Medical Genetics, vol. 9, no. 2, pp. 197–202, 1972. View at Google Scholar
  13. D. J. P. Barker, E. Dixon, and J. F. Taylor, “Perthes' disease of the hip in three regions of England,” Journal of Bone and Joint Surgery. British, vol. 60, no. 4, pp. 478–480, 1978. View at Google Scholar
  14. M. K. Molloy and B. MacMahon, “Incidence of Legg-Perthes disease (osteochondritis deformans),” New England Journal of Medicine, vol. 275, no. 18, pp. 988–990, 1966. View at Google Scholar
  15. A. J. Hall and D. J. P. Barker, “Perthes' disease in Yorkshire,” Journal of Bone and Joint Surgery. British, vol. 71, no. 2, pp. 229–233, 1989. View at Google Scholar
  16. A. Moberg and L. Rehnberg, “Incidence of Perthes' disease in Uppsala, Sweden,” Acta Orthopaedica Scandinavica, vol. 63, no. 2, pp. 157–158, 1992. View at Google Scholar
  17. O. Wiig, T. Terjesen, S. Svenningsen, and S. A. Lie, “The epidemiology and aetiology of Perthes' disease in Norway,” Journal of Bone and Joint Surgery. British, vol. 88, no. 9, pp. 1217–1223, 2006. View at Publisher · View at Google Scholar · View at PubMed
  18. B. M. Margetts, C. A. Perry, J. F. Taylor, and P. H. Dangerfield, “The incidence and distribution of Legg-Calvé-Perthes' disease in Liverpool, 1982-95,” Archives of Disease in Childhood, vol. 84, no. 4, pp. 351–354, 2001. View at Publisher · View at Google Scholar
  19. W. D. C. Kealey, A. J. Moore, S. Cook, and A. P. Cosgrove, “Deprivation, urbanization and Perthes' disease in Northern Ireland,” Journal of Bone and Joint Surgery. British, vol. 82, no. 2, pp. 167–171, 2000. View at Google Scholar
  20. A. Pillai, S. Atiya, and P. S. Costigan, “The incidence of Perthes' disease in Southwest Scotland,” Journal of Bone and Joint Surgery. British, vol. 87, no. 11, pp. 1531–1535, 2005. View at Publisher · View at Google Scholar · View at PubMed
  21. A. J. Hall, D. J. P. Barker, P. H. Dangerfield, and J. F. Taylor, “Perthes' disease of the hip in Liverpool,” British Medical Journal, vol. 287, no. 6407, pp. 1757–1759, 1983. View at Google Scholar
  22. S. D. Niclasen, “Incidence of Legg-Calve-Perthes' disease in the Faroe Islands,” Annales Societatis Scientiarum Faroensis, vol. 22, pp. 9–65, 1974. View at Google Scholar
  23. P. B. Eveleth and J. M. Tanner, Worldwide Variation in Human Growth, Cambridge University Press, Cambridge, UK, 2nd edition, 1990.
  24. R. Wynne-Davies and J. Gormley, “The aetiology of Perthes' disease: genetic, epidemiological and growth factors in 310 Edinburgh and Glasgow patients,” Journal of Bone and Joint Surgery. British, vol. 60, no. 1, pp. 6–14, 1978. View at Google Scholar
  25. D. J. P. Barker and A. J. Hall, “The epidemiology of Perthes' disease,” Clinical Orthopaedics and Related Research, vol. 209, pp. 89–94, 1986. View at Google Scholar
  26. S. Sharma, M. Sibinski, and D. A. Sherlock, “A profile of Perthes' disease in Greater Glasgow. Is there an association with deprivation?” Journal of Bone and Joint Surgery. British, vol. 87, no. 11, pp. 1536–1540, 2005. View at Publisher · View at Google Scholar · View at PubMed
  27. A. A. Faraj and A. B. Nevelos, “Ethnic factors in perthes disease: a retrospective study among white and Asian population living in the same environment,” Acta Orthopaedica Belgica, vol. 66, no. 3, pp. 255–258, 2000. View at Google Scholar
  28. R. L. Fisher, “An epidemiological study of Legg-Perthes disease,” Journal of Bone and Joint Surgery. American, vol. 54, no. 4, pp. 769–778, 1972. View at Google Scholar
  29. S. B. Rosenfeld, J. A. Herring, and J. C. Chao, “Legg-Calvé-Perthes disease: a review of cases with onset before six years of age,” Journal of Bone and Joint Surgery. American, vol. 89, no. 12, pp. 2712–2722, 2007. View at Publisher · View at Google Scholar · View at PubMed
  30. O. Wiig, T. Terjesen, and S. Svenningsen, “Prognostic factors and outcome of treatment in Perthes' disease: a prospective study of 368 patients with five-year follow-up,” Journal of Bone and Joint Surgery. British, vol. 90, no. 10, pp. 1364–1371, 2008. View at Publisher · View at Google Scholar · View at PubMed
  31. G. E. Fulford, P. G. Lunn, and M. F. Macnicol, “A prospective study of nonoperative and operative management for Perthes' disease,” Journal of Pediatric Orthopaedics, vol. 13, no. 3, pp. 281–285, 1993. View at Google Scholar
  32. J. T. Guille, G. E. Lipton, G. Szöke, J. R. Bowen, H. T. Harcke, and J. J. Glutting, “Legg-Calve-Perthes disease in girls. A comparison of the results with those seen in boys,” Journal of Bone and Joint Surgery. American, vol. 80, no. 9, pp. 1256–1263, 1998. View at Google Scholar
  33. N. H. Wang, F. T. Lee, L. S. Chin, and W. H. Lo, “Legg-Calve-Perthes disease: clinical analysis of 57 cases,” Journal of the Formosan Medical Association, vol. 89, no. 9, pp. 764–771, 1990. View at Google Scholar
  34. J. G. Petrie and I. Bitenc, “The abduction weight-bearing treatment in Legg-Perthes' disease,” Journal of Bone and Joint Surgery. British, vol. 53, no. 1, pp. 54–62, 1971. View at Google Scholar
  35. J. A. Herring, T. K. Hui, and R. Browne, “Legg-Calvé-Perthes disease. Part II: prospective multicenter study of the effect of treatment on outcome,” Journal of Bone and Joint Surgery. American, vol. 86, no. 10, pp. 2121–2134, 2004. View at Google Scholar
  36. V. Chacko, B. Joseph, and B. Seetharam, “Perthes' disease in South India,” Clinical Orthopaedics and Related Research, vol. 209, pp. 95–99, 1986. View at Google Scholar
  37. M. O'Sullivan, S. K. O'Rourke, and P. MacAuley, “Legg-Calve-Perthes disease in a family: genetic or environmental,” Clinical Orthopaedics and Related Research, vol. 199, pp. 179–181, 1985. View at Google Scholar
  38. Y. Miyamoto, T. Matsuda, H. Kitoh et al., “A recurrent mutation in type II collagen gene causes Legg-Calvé-Perthes disease in a Japanese family,” Human Genetics, vol. 121, no. 5, pp. 625–629, 2007. View at Publisher · View at Google Scholar · View at PubMed
  39. P. Su, R. Li, S. Liu et al., “Age at onset-dependent presentations of premature hip osteoarthritis, avascular necrosis of the femoral head, or legg-calvé-perthes disease in a single family, consequent upon a p.Gly1170Ser mutation of COL2A1,” Arthritis and Rheumatism, vol. 58, no. 6, pp. 1701–1706, 2008. View at Publisher · View at Google Scholar · View at PubMed
  40. F. E. Stephens and J. P. Kerby, “Hereditary Legg-Calve-Perthes' disease,” Journal of Heredity, vol. 37, no. 5, pp. 153–160, 1946. View at Google Scholar
  41. E. McComas, “Perthes' disease and its occurrence as a familial condition,” The Medical Journal of Australia, vol. 2, pp. 584–585, 1946. View at Google Scholar
  42. H. Burlington, “Legg-Perthes disease in siblings; a report of two cases with simultaneous onset,” Pennsylvania Medical Journal, vol. 61, no. 7, pp. 887–888, 1958. View at Google Scholar
  43. H. W. Tracy, “Coxa plana in siblings,” North Carolina Medical Journal, vol. 24, pp. 76–79, 1963. View at Google Scholar
  44. D. J. Hall, “Genetic aspects of Perthes' disease: a critical review,” Clinical Orthopaedics and Related Research, vol. 209, pp. 100–114, 1986. View at Google Scholar
  45. P. S. Harper, B. J. Brotherton, and D. Cochlin, “Genetic risks in Perthes' disease,” Clinical Genetics, vol. 10, no. 3, pp. 178–182, 1976. View at Google Scholar
  46. Z. Wamoscher and A. Farhi, “Hereditary Legg-Calve-Perthes disease,” American Journal of Diseases of Children, vol. 106, pp. 97–100, 1963. View at Google Scholar
  47. S. D. Niclasen, “Family studies of relation between Perthes disease and congenital dislocation of the hip,” Journal of Medical Genetics, vol. 15, no. 4, pp. 296–299, 1978. View at Google Scholar
  48. A. Inglis, “Genetic implications in coxa plana,” The Journal of Bone and Joint Surgery. American, vol. 42-A, pp. 711–715, 1960. View at Google Scholar
  49. N. Giannestras, “Legg-Perthes disease in twins,” The Journal of Bone and Joint Surgery. American, vol. 36-A, pp. 149–152, 1954. View at Google Scholar
  50. A. W. Dunn, “Coxa plana in monozygotic male twins,” The Journal of Bone and Joint Surgery. American, vol. 42-A, pp. 178–183, 1960. View at Google Scholar
  51. L. Söderberg, “Simultaneous occurrence of coxa plana in enzygotic twins,” Acta Orthopaedica Scandinavica, vol. 27, pp. 135–140, 1957. View at Google Scholar
  52. P. S. Derian, “Coxa plana in dizygotic male twins,” The Journal of Bone and Joint Surgery. American, vol. 38-A, pp. 901–907, 1956. View at Google Scholar
  53. J. P. Livesey, S. M. Hay, and M. J. Bell, “Perthes disease affecting three female first-degree relatives,” Journal of Pediatric Orthopaedics Part B, vol. 7, no. 3, pp. 230–231, 1998. View at Google Scholar
  54. J. Bertrams, P. Schiersmann, and G. Ritgen, “HLA antigens in Perthes' disease,” Tissue Antigens, vol. 12, no. 2, pp. 157–158, 1978. View at Google Scholar
  55. J. Zervas, S. Theordorou, and C. Constantopoulos, “HLA-A1 probable association with Perthes' disease,” Tissue Antigens, vol. 20, no. 2, pp. 159–160, 1982. View at Google Scholar
  56. I. A. E. Halwag, E. M. K. El-Abbasy, S. A. Zaki, and M. A. Abou-Khatwn, “Association between HLA-A and -B and Perthes' disease,” Journal of the Medical Research Institute, vol. 12, pp. 89–98, 1991. View at Google Scholar
  57. C. Dostál, V. Raušer, S. Popelka, E. Ivašková, M. Macurová, and J. Zvárová, “HLA antigens in Perthes disease,” Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca, vol. 54, pp. 324–329, 1987. View at Google Scholar
  58. S. K. Thompson and J. C. Woodrow, “HLA antigens in Perthes' disease,” Journal of Bone and Joint Surgery. British, vol. 63, no. 2, pp. 278–279, 1981. View at Google Scholar
  59. J. Mach and S. Wegener, “HLA-examinations at Perthes disease,” Beitrage zur Orthopadie und Traumatologie, vol. 32, no. 12, pp. 590–592, 1985. View at Google Scholar
  60. J. M. Cameron and M. M. Izatt, “The ABO and rhesus blood groups in Perthes' disease,” Journal of Clinical Pathology, vol. 15, pp. 163–168, 1962. View at Google Scholar
  61. D. J. Hall, M. H. M. Harrison, and R. G. Burwell, “Congenital abnormalities and Perthes' disease. Clinical evidence that children with Perthes' disease may have a major congenital defect,” Journal of Bone and Joint Surgery. British, vol. 61, no. 1, pp. 18–25, 1979. View at Google Scholar
  62. M. K. Molloy and B. Macmahon, “Birth weight and Legg-Perthes disease,” Journal of Bone and Joint Surgery. American, vol. 49, no. 3, pp. 498–506, 1967. View at Google Scholar
  63. K. Lappin, D. Kealey, A. Cosgrove, and K. Graham, “Does low birthweight predispose to Perthes' disease? Perthes' disease in twins,” Journal of Pediatric Orthopaedics Part B, vol. 12, no. 5, pp. 307–310, 2003. View at Google Scholar
  64. D. S. Weiner and H. W. O'Dell, “Legg-Calvé-Perthes disease. Observations on skeletal maturation,” Clinical Orthopaedics and Related Research, vol. 68, pp. 44–49, 1970. View at Google Scholar
  65. S. Motokawa, “Effect of serum factors on skeletal growth in Perthes' disease,” Journal of the Japanese Orthopaedic Association, vol. 64, no. 9, pp. 790–797, 1990. View at Google Scholar
  66. G. Eckerwall, H. Wingstrand, G. Hägglund, and J. Karlberg, “Growth in 110 children with Legg-Calve-Perthes' disease: a longitudinal infancy childhood puberty growth model study,” Journal of Pediatric Orthopaedics Part B, vol. 5, no. 3, pp. 181–184, 1996. View at Google Scholar
  67. F. Shapiro, “Legg-Calve-Perthes disease. A study of lower extremity length discrepancies and skeletal maturation,” Acta Orthopaedica Scandinavica, vol. 53, no. 3, pp. 437–444, 1982. View at Google Scholar
  68. W. D. C. Kealey, K. J. Lappin, H. Leslie, B. Sheridan, and A. P. Cosgrove, “Endocrine profile and physical stature of children with Perthes disease,” Journal of Pediatric Orthopaedics, vol. 24, no. 2, pp. 161–166, 2004. View at Google Scholar
  69. Z. Laron, A. Axer, and Z. Drezner, “Growth and development of children with Legg Calve Perthes syndrome in Israel,” Israel Journal of Medical Sciences, vol. 9, no. 5, pp. 612–616, 1973. View at Google Scholar
  70. R. G. Burwell, P. H. Dangerfield, and D. J. Hall, “Perthes' disease. An anthropometric study revealing impaired and disproportionate growth,” Journal of Bone and Joint Surgery. British, vol. 60, no. 4, pp. 461–477, 1978. View at Google Scholar
  71. A. J. Hall, D. J. P. Barker, P. H. Dangerfield, C. Osmond, and J. F. Taylor, “Small feet and Perthes' disease. A survey in Liverpool,” Journal of Bone and Joint Surgery. British, vol. 70, no. 4, pp. 611–613, 1988. View at Google Scholar
  72. B. S. Rao, B. Joseph, V. Chacko, and A. J. Hall, “Altered skeletal growth in Perthes' disease: an anthropometric study of children from rural India,” Journal of Pediatric Orthopaedics. Part B, vol. 4, no. 1, pp. 91–94, 1995. View at Google Scholar
  73. W. W. Greulich and S. I. Pyle, Radiographic Atlas of Skeletal Development of the Hand and Wrist, Stanford University Press, Stanford, Calif, USA, 2nd edition, 1959.
  74. R. M. Acheson, “The Oxford method of assessing skeletal maturity,” Clinical orthopaedics, vol. 10, pp. 19–39, 1957. View at Google Scholar
  75. R. T. Loder, F. A. Farley, J. A. Herring, M. A. Schork, and Y. Shyr, “Bone age determination in children with Legg-Calve-Perthes disease: a comparison of two methods,” Journal of Pediatric Orthopaedics, vol. 15, no. 1, pp. 90–94, 1995. View at Google Scholar
  76. M. H. M. Harrison, M. H. Turner, and P. Jacobs, “Skeletal immaturity in Perthes' disease,” Journal of Bone and Joint Surgery. British, vol. 58, no. 1, pp. 37–40, 1976. View at Google Scholar
  77. F. Kristmundsdottir, R. G. Burwell, D. J. Hall, and W. A. Marshall, “A longitudinal study of carpal bone development in Perthes' disease: its significance for both radiologic standstill and bilateral disease,” Clinical Orthopaedics and Related Research, vol. 209, pp. 115–123, 1986. View at Google Scholar
  78. F. Kristmundsdottir, R. G. Burwell, and M. H. M. Harrison, “Delayed skeletal maturation in Perthes' disease,” Acta Orthopaedica Scandinavica, vol. 58, no. 3, pp. 277–279, 1987. View at Google Scholar
  79. S. T. Lee, S. V. Vaidya, H. R. Song, S. H. Lee, S. W. Suh, and S. S. Telang, “Bone age delay patterns in legg-calvé-perthes disease: an analysis using the tanner and whitehouse 3 method,” Journal of Pediatric Orthopaedics, vol. 27, no. 2, pp. 198–203, 2007. View at Publisher · View at Google Scholar · View at PubMed
  80. V. M. R. Vila-Verde and K. C. Da Silva, “Bone age delay in Perthes disease and transient synovitis of the hip,” Clinical Orthopaedics and Related Research, no. 385, pp. 118–123, 2001. View at Google Scholar
  81. N. A. N. Zarco, J. M. Morán, and M. A. Hernández, “Delay in skeletal maturity in Mexican patients with Legg-Calvé-Perthes,” Acta Ortopédica Mexicana, vol. 22, no. 3, pp. 157–161, 2008. View at Google Scholar
  82. Y. Nishi, T. Tanaka, K. Fujieda et al., “Slipped capital femoral epiphysis, Perthes' disease and scoliosis in children with growth hormone deficiency,” Endocrine Journal, vol. 45, pp. S167–S169, 1998. View at Google Scholar
  83. P. H. W. Rayner, S. L. Schwalbe, and D. J. Hall, “An assessment of endocrine function in boys with Perthes' disease,” Clinical Orthopaedics and Related Research, vol. 209, pp. 124–128, 1986. View at Google Scholar
  84. H. Tanaka, K. Tamura, and K. Takano, “Serum somatomedin A in Perthes' disease,” Acta Orthopaedica Scandinavica, vol. 55, no. 2, pp. 135–140, 1984. View at Google Scholar
  85. R. G. Burwell, C. L. Vernon, and P. H. Dangerfield, “Raised somatomedin activity in the serum of young boys with Perthes' disease revealed by bioassay: a disease of growth transition?” Clinical Orthopaedics and Related Research, vol. 209, pp. 129–138, 1986. View at Google Scholar
  86. T. Kitsugi, Y. Kasahara, Y. Seto, and S. Komai, “Normal somatomedin-C activity measured by radioimmunoassay in Perthes' disease,” Clinical Orthopaedics and Related Research, no. 244, pp. 217–221, 1989. View at Google Scholar
  87. J. Neidel, D. Zander, and M. H. Hackenbroch, “Low plasma levels of insulin-like growth factor I in Perthes' disease. A controlled study of 59 consecutive children,” Acta Orthopaedica Scandinavica, vol. 63, no. 4, pp. 393–398, 1992. View at Google Scholar
  88. J. Neidel, E. Schonau, D. Zander, J. Rutt, and M. H. Hackenbroch, “Normal plasma levels of IGF binding protein in Perthes' disease. Follow-up of previous report,” Acta Orthopaedica Scandinavica, vol. 64, no. 5, pp. 540–542, 1993. View at Google Scholar
  89. P. M. Crofton, C. Macfarlane, B. Wardhaugh et al., “Children with acute Perthes' disease have asymmetrical lower leg growth and abnormal collagen turnover,” Acta Orthopaedica, vol. 76, no. 6, pp. 841–847, 2005. View at Publisher · View at Google Scholar · View at PubMed
  90. T. Matsumoto, H. Enomoto, K. Takahashi, and S. Motokawa, “Decreased levels of IGF binding protein-3 in serum from children with Perthes' disease,” Acta Orthopaedica Scandinavica, vol. 69, no. 2, pp. 125–128, 1998. View at Google Scholar
  91. H. Grasemann, R. D. Nicolai, B. P. Hauffa, W. Reinhardt, H. Nicolai, and M. Hövel, “Skeletal immaturity, IGF-I and IGFBP-3 serum concentrations in Legg-Calve-Perthes disease (skeletal immaturity, IGF-I and IGFBP-3 in LCPD),” Klinische Padiatrie, vol. 208, no. 6, pp. 339–343, 1996. View at Google Scholar
  92. T. T. Lahdes-Vasama, I. S. J. Sipilä, S. Lamminranta, S. H. Pihko, E. O. J. Merikanto, and E. J. Marttinen, “Psychosocial development and premorbid skeletal growth in legg-calve- perthes disease: a study of nineteen patients,” Journal of Pediatric Orthopaedics Part B, vol. 6, no. 2, pp. 133–137, 1997. View at Google Scholar
  93. R. W. Emerick, K. E. Corrigan, A. H. Joistad Jr., and L. E. Holly, “Thyroid function in Legg-Calve-Perthes disease—a new approach to an old problem,” Clinical Orthopaedics and Related Research, vol. 4, pp. 160–165, 1954. View at Google Scholar
  94. L. A. Cavanaugh, E. K. Shelton, S. Barbara, and R. Sutherland, “Metabolic studies in osteochondritis of the capital femoral epiphysis,” The Journal of Bone and Joint Surgery. American, vol. 18, pp. 957–968, 1936. View at Google Scholar
  95. A. B. Gill, “Relationship of Legg-Perthes disease to the function of the thyroid gland,” The Journal of Bone and Joint Surgery. American, vol. 25-A, pp. 892–901, 1943. View at Google Scholar
  96. J. F. Katz, “Protein-bound iodine in Legg-Calvé-Perthes disease,” The Journal of Bone and Joint Surgery. American, vol. 37, no. 4, pp. 842–846, 1955. View at Google Scholar
  97. D. D. Beiler and W. H. Love, “Thyroid function in Legg-Perthes disease,” The Journal of Bone and Joint Surgery. American, vol. 38, no. 6, pp. 1320–1322, 1956. View at Google Scholar
  98. E. M. Chapman, “Thyroid function in Legg-Perthes disease,” The New England journal of medicine, vol. 255, no. 6, pp. 289–290, 1956. View at Google Scholar
  99. S. Bahmanyar, S. M. Montgomery, R. J. Weiss, and A. Ekbom, “Maternal smoking during pregnancy, other prenatal and perinatal factors, and the risk of legg-calvé-perthes disease,” Pediatrics, vol. 122, no. 2, pp. e459–e464, 2008. View at Publisher · View at Google Scholar · View at PubMed
  100. J. E. Gordon, P. L. Schoenecker, J. D. Osland, M. B. Dobbs, D. A. Szymanski, and S. J. Luhmann, “Smoking and socio-economic status in the etiology and severity of Legg-Calvé-Perthes' disease,” Journal of Pediatric Orthopaedics Part B, vol. 13, no. 6, pp. 367–370, 2004. View at Google Scholar
  101. S. García Mata, E. Ardanaz Aicua, A. Hidalgo Ovejero, and M. Martinez Grande, “Legg-Calvé-Perthes disease and passive smoking,” Journal of Pediatric Orthopaedics, vol. 20, no. 3, pp. 326–330, 2000. View at Google Scholar
  102. C. J. Glueck, R. A. Freiberg, A. Crawford et al., “Secondhand smoke, hypofibrinolysis, and Legg-Perthes disease,” Clinical Orthopaedics and Related Research, no. 352, pp. 159–167, 1998. View at Google Scholar
  103. A. Dilley, W. C. Hooper, H. Austin et al., “The beta fibrinogen gene G-455-A polymorphism is a risk factor for Legg-Perthes disease,” Journal of Thrombosis and Haemostasis, vol. 1, no. 11, pp. 2317–2321, 2003. View at Google Scholar
  104. R. M. Bertina, B. P. C. Koeleman, T. Koster et al., “Mutation in blood coagulation factor V associated with resistance to activated protein C,” Nature, vol. 369, no. 6475, pp. 64–67, 1994. View at Publisher · View at Google Scholar · View at PubMed
  105. C. J. Glueck, T. Tracy, and P. Wang, “Legg-calve-perthes disease, venous and arterial thrombi, and the factor V leiden mutation in a four-generation kindred,” Journal of Pediatric Orthopaedics, vol. 27, no. 7, pp. 834–837, 2007. View at Publisher · View at Google Scholar · View at PubMed
  106. R. Gruppo, C. J. Glueck, E. Wall, D. Roy, and P. Wang, “Legg-Perthes disease in three siblings, two heterozygous and one homozygous for the factor V Leiden mutation,” Journal of Pediatrics, vol. 132, no. 5, pp. 885–888, 1998. View at Publisher · View at Google Scholar
  107. C. J. Glueck, G. Brandt, R. Gruppo et al., “Resistance to activated protein C and Legg-Perthes disease,” Clinical Orthopaedics and Related Research, no. 338, pp. 139–152, 1997. View at Google Scholar
  108. K. Szepesi, E. Pósán, J. Hársfalvi et al., “The most severe forms of Perthes' disease associated with the homozygous Factor V Leiden mutation,” Journal of Bone and Joint Surgery. British, vol. 86, no. 3, pp. 426–429, 2004. View at Publisher · View at Google Scholar
  109. L. L. O. Sanders, M. B. Braga Júnior, C. W. M. Cima, R. M. S. Mota, M. I. M. C. Pardini, and S. H. B. Rabenhorst, “Leiden's V-factor in Legg-Calvé-Perthes disease,” Acta Ortopedica Brasileira, vol. 17, no. 2, pp. 40–42, 2009. View at Publisher · View at Google Scholar
  110. V. V. Balasa, R. A. Gruppo, C. J. Glueck et al., “Legg-Calvé-Perthes disease and thrombophilia,” Journal of Bone and Joint Surgery. American, vol. 86, no. 12, pp. 2642–2647, 2004. View at Google Scholar
  111. J. Eldridge, A. Dilley, H. Austin et al., “The role of protein C, protein S, and resistance to activated protein C in Legg-Perthes disease,” Pediatrics, vol. 107, no. 6, pp. 1329–1334, 2001. View at Publisher · View at Google Scholar
  112. V. R. Arruda, W. D. Belangero, M. C. Ozelo et al., “Inherited risk factors for thrombophilia among children with Legg-Calve-Perthes disease,” Journal of Pediatric Orthopaedics, vol. 19, no. 1, pp. 84–87, 1999. View at Publisher · View at Google Scholar
  113. A. Vosmaer, R. R. Pereira, J. S. Koenderman, F. R. Rosendaal, and S. C. Cannegieter, “Coagulation abnormalities in Legg-Calvé-Perthes disease,” Journal of Bone and Joint Surgery. American, vol. 92, no. 1, pp. 121–128, 2010. View at Publisher · View at Google Scholar · View at PubMed
  114. C. J. Glueck, H. I. Glueck, D. Greenfield et al., “Protein C and S deficiency, thrombophilia, and hypofibrinolysis: pathophysiologic causes of Legg-Perthes disease,” Pediatric Research, vol. 35, no. 4, pp. 383–388, 1994. View at Google Scholar
  115. C. J. Glueck, A. Crawford, D. Roy, R. Freiberg, H. Glueck, and D. Stroop, “Association of antithrombotic factor deficiencies and hypofibrinolysis with Legg-Perthes disease,” Journal of Bone and Joint Surgery. American, vol. 78, no. 1, pp. 3–13, 1996. View at Google Scholar
  116. K. H. Koo, H. R. Song, Y. C. Ha et al., “Role of thrombotic and fibrinolytic disorders in the etiology of Perthes' disease,” Clinical Orthopaedics and Related Research, no. 399, pp. 162–167, 2002. View at Google Scholar
  117. D. Yilmaz, L. Karapinar, B. Karapinar, H. Ozturk, and K. Kavakli, “Evaluation of anticoagulant system in Turkish children with Perthes disease,” Pediatrics International, vol. 47, no. 1, pp. 43–48, 2005. View at Publisher · View at Google Scholar · View at PubMed
  118. W. D. C. Kealey, E. E. Mayne, W. McDonald, P. Murray, and A. P. Cosgrove, “The role of coagulation abnormalities in the development of Perthe's disease,” Journal of Bone and Joint Surgery. British, vol. 82, no. 5, pp. 744–746, 2000. View at Google Scholar
  119. M. T. Hresko, P. A. McDougall, J. B. Gorlin, E. C. Vamvakas, J. R. Kasser, and E. J. Neufeld, “Prospective reevaluation of the association between thrombotic diathesis and legg-perthes disease,” Journal of Bone and Joint Surgery. American, vol. 84, no. 9, pp. 1613–1618, 2002. View at Google Scholar
  120. M. López-Franco, G. González-Morán, J. C. De Lucas et al., “Legg-Perthes disease and heritable thrombophilia,” Journal of Pediatric Orthopaedics, vol. 25, no. 4, pp. 456–459, 2005. View at Publisher · View at Google Scholar
  121. S. Gallistl, T. Reitinger, W. Linhart, and W. Muntean, “The role of inherited thrombotic disorders in the etiology of Legg-Calve-Perthes disease,” Journal of Pediatric Orthopaedics, vol. 19, no. 1, pp. 82–83, 1999. View at Publisher · View at Google Scholar
  122. J. S. Mehta, M. E. Conybeare, B. L. Hinves, and J. B. M. Winter, “Protein C levels in patients with Legg-Calve-Perthes disease: is it a true deficiency?” Journal of Pediatric Orthopaedics, vol. 26, no. 2, pp. 200–203, 2006. View at Publisher · View at Google Scholar · View at PubMed
  123. R. Shiba and S. Fujii, “Legg-Calve-Perthes in children. Letter to the editor,” Clinical Orthopaedics and Related Research, vol. 363, pp. 268–269, 1999. View at Google Scholar
  124. G. Kenet, E. Ezra, S. Wientroub et al., “Perthes' disease and the search for genetic associations: collagen mutations, Gaucher's disease and thrombophilia,” Journal of Bone and Joint Surgery. British, vol. 90, no. 11, pp. 1507–1511, 2008. View at Publisher · View at Google Scholar · View at PubMed
  125. S. Hayek, G. Kenet, A. Lubetsky, N. Rosenberg, S. Gitel, and S. Wientroub, “Does thrombophilia play an aetiological role in Legg-Calve-Perthes disease?” Journal of Bone and Joint Surgery. British, vol. 81, no. 4, pp. 686–690, 1999. View at Publisher · View at Google Scholar
  126. N. Sirvent, F. Fisher, T. El Hayek, A. Appert, H. Giudicelli, and J. Griffet, “Absence of congenital prethrombotic disorders in children with Legg-Perthes disease,” Journal of Pediatric Orthopaedics Part B, vol. 9, no. 1, pp. 24–27, 2000. View at Google Scholar
  127. M. A. Matos, “The role of protein C deficiency in the etiology of Perthes disease,” Ortopedia Traumatologia Rehabilitacja, vol. 10, no. 3, pp. 274–278, 2008. View at Google Scholar
  128. M. C. Aksoy, D. Y. Aksoy, I. C. Haznedaroglu, N. Sayinalp, S. Kirazli, and M. Alpaslan, “Enhanced tissue factor pathway inhibitor response as a defense mechanism against ongoing local microvascular events of Legg-Calve-Perthes disease,” Pediatric Hematology and Oncology, vol. 22, no. 5, pp. 391–399, 2005. View at Publisher · View at Google Scholar · View at PubMed
  129. R. G. Kleinman and E. E. Bleck, “Increased blood viscosity in patients with Legg-Perthes disease: a preliminary report,” Journal of Pediatric Orthopaedics, vol. 1, no. 2, pp. 131–136, 1981. View at Google Scholar
  130. M. C. Aksoy, D. Y. Aksoy, I. C. Haznedaroglu, N. Sayinalp, S. Kirazli, and M. Alpaslan, “Thrombomodulin and GFC levels in Legg-Calve-Perthes disease,” Hematology, vol. 13, no. 6, pp. 324–328, 2008. View at Publisher · View at Google Scholar · View at PubMed
  131. B. Westhoff, R. Krauspe, A. E. Kalke et al., “Urinary excretion of deoxypyridinoline in Perthes' disease. A prospective, controlled comparative study in 83 children,” Journal of Bone and Joint Surgery. British, vol. 88, no. 7, pp. 967–971, 2006. View at Publisher · View at Google Scholar · View at PubMed
  132. I. Orfanos, C. Magkou, I. Anastasopoulos, E. Karanikas, and N. M. Sitaras, “Urine glycosaminoglycans in children with transient hip synovitis and Perthes disease,” Journal of Pediatric Orthopaedics Part B, vol. 14, no. 2, pp. 92–96, 2005. View at Google Scholar
  133. G. Eckerwall, L. Stefan Lohmander, and H. Wingstrand, “Increased levels of proteoglycan fragments and stromelysin in hip joint fluid in Legg-Calve-Perthes disease,” Journal of Pediatric Orthopaedics, vol. 17, no. 2, pp. 266–269, 1997. View at Publisher · View at Google Scholar
  134. M. H. M. Harrison and M. E. Blakemore, “A study of the 'normal' hip in children with unilateral Perthes' disease,” Journal of Bone and Joint Surgery. British, vol. 62, no. 1, pp. 31–36, 1980. View at Google Scholar
  135. E. Arie, F. Johnson, and M. H. M. Harrison, “Femoral head shape in Perthes' disease: is the contralateral hip abnormal?” Clinical Orthopaedics and Related Research, vol. 209, pp. 77–88, 1986. View at Google Scholar
  136. G. Kandzierski, T. Karski, and K. Kozlowski, “Capital femoral epiphysis and growth plate of the asymptomatic hip joint in unilateral Perthes disease,” Journal of Pediatric Orthopaedics Part B, vol. 12, no. 6, pp. 380–386, 2003. View at Publisher · View at Google Scholar
  137. H. Kitoh, T. Kitakoji, M. Katoh, and Y. Takamine, “Delayed ossification of the proximal capital femoral epiphysis in Legg-Calvé-Perthes' disease,” Journal of Bone and Joint Surgery. British, vol. 85, no. 1, pp. 121–124, 2003. View at Publisher · View at Google Scholar
  138. W. E. Fitzgerald, A psychological factor in Legg-Perthes-Calvé disease, Ph.D. thesis, Harvard University, Boston, Mass, USA, 1961.
  139. R. T. Loder, E. M. Schwartz, and R. N. Hensinger, “Behavioral characteristics of children with Legg-Calve-Perthes disease,” Journal of Pediatric Orthopaedics, vol. 13, no. 5, pp. 598–601, 1993. View at Google Scholar
  140. A. Catterall, G. C. Roberts, and R. Wynne-Davies, “Association of Perthes' disease with congenital anomalies of genitourinary tract and inguinal region,” Lancet, vol. 1, no. 7707, pp. 996–997, 1971. View at Google Scholar
  141. M. Makin, S. Meyer, and A. N. Gilai, “Perthes' disease and posterior lumbosacral union,” Journal of Pediatric Orthopaedics, vol. 12, no. 5, pp. 607–609, 1992. View at Google Scholar
  142. J. F. Katz, “Spina bifida occulta in Legg-Calvé-Perthes disease,” Clinical Orthopaedics and Related Research, vol. 14, pp. 110–118, 1959. View at Google Scholar
  143. H. Kitoh, T. Kitakoji, M. Katoh, and N. Ishiguro, “Sagittal spinal alignment in patients with Legg-Calve-Perthes disease,” Pediatrics International, vol. 49, no. 5, pp. 612–617, 2007. View at Publisher · View at Google Scholar · View at PubMed
  144. A. J. Hall, B. M. Margetts, D. J. P. Barker et al., “Low blood manganese levels in Liverpool children with Perthes' disease,” Paediatric and Perinatal Epidemiology, vol. 3, no. 2, pp. 131–136, 1989. View at Google Scholar
  145. C. A. Perry, J. F. Taylor, A. Nunn, P. H. Dangerfield, and H. Delves, “Perthes' disease and blood manganese levels,” Archives of Disease in Childhood, vol. 82, no. 5, pp. 429–430, 2000. View at Google Scholar
  146. B. Joseph, “Serum immunoglobulin in Perthes' disease,” Journal of Bone and Joint Surgery. British, vol. 73, no. 3, pp. 509–510, 1991. View at Google Scholar
  147. J. A. Matsoukas, “Viral antibody titers to rubella in coxa plana or Perthes' disease. Perthes' disease: is it the late osseous residua of a minor prenatal rubella?” Acta Orthopaedica Scandinavica, vol. 46, no. 6, pp. 957–962, 1975. View at Google Scholar
  148. W. Jansen and A. A. J. M. Hazebroek-Kampschreur, “Differences in height and weight between children living in neighbourhoods of different socioeconomic status,” Acta Paediatrica, vol. 86, no. 2, pp. 224–225, 1997. View at Google Scholar