Assessment of Results in Adults

The aim of this paper is to determine the late results of idiopathic pseudocoxalgia (Legg-Calv#{233}-Perthes disease) in adult life. It is hoped to obtain some idea of the efficiency of treatment and of the factors that influence prognosis. In the enormous literature of this condition, only three papers can be found which contain reports of cases which have been observed for long periods. Legg (1927) reviewed forty cases for ten or more years. He divided these cases into two types, the “ cap “ and the “ mushroom.” He stated that : “ Ultimately the cases of both types will never be incapacitated. In the majority they will tire after long standing and walking, or after movements that require extreme abduction. More than half the cases will probably show a persistent limp.” Unfortunately he gave neither details nor case histories. Mindell and Sherman (1951) reviewed seventy-eight hips in seventy-two patients, but only twenty-two hips were observed for sixteen years or more. They stated that most patients had some residual effects, but even those with the worst results were not severely handicapped. They grouped the immediate and late results together, and it is therefore difficult to compare their results with those presented in this paper. On the other hand, the third paper, that of Branciforti and Montina (1954) (a study of twelve hips followed up for an average of twenty-four years) concluded that the fate of these hips is a severe one ‘ ‘ leading us to erase from our minds all that we have ever read about osteochondritis of the hip.”