On the day of her 14th birthday, Millie was driving from South Wales to London with her mum, Vicki, for her long-awaited scoliosis operation. "It was the best birthday present I could ask for," says Millie, who is from Blaenrhondda in the Rhonda Valley, "being given a perfectly straight back."
Perthes' disease
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PERTHES’ DISEASE CARE AT HCA HEALTHCARE UK
Why choose us?
Any issue with your child’s bone structure or mobility can be a cause for concern. Our teams include some of the UK’s leading paediatric orthopaedic consultants and surgeons, and they’re committed to making sure your child has dedicated, wrap-around care at every stage.
HCA UK is No 1 in London for private orthopaedic care. Our state-of-the-art diagnostic and imaging technology means your child’s condition will be rapidly diagnosed. A specialist team can then recommend the specific course of treatment required, so you and your child can get back to regular life as soon as possible.
HCA UK is No 1 in London for private orthopaedic care. Our state-of-the-art diagnostic and imaging technology means your child’s condition will be rapidly diagnosed. A specialist team can then recommend the specific course of treatment required, so you and your child can get back to regular life as soon as possible.
Perthes’ disease, sometimes called Legg-Calve-Perthes’ disease, is a childhood condition that can affect a child’s hip and mobility for several years. It happens when there’s an interrupted blood supply to the ball part of the hip joint (or femoral head) which leads to bone damage.
Most children recover well, and the hip joint keeps functioning as normal, but it can take time.
Most children recover well, and the hip joint keeps functioning as normal, but it can take time.
Perthes’ disease has four stages that run in a continuous cycle, which can sometimes take several years to complete.
Onset stage
This occurs when the blood supply to the top of your child’s thigh bone - the femoral head - becomes restricted. It causes the bone cells to die, and as the thigh bone softens, it can fragment or collapse. This can lead to intense inflammation and irritation, potentially affecting your child’s mobility. This stage may last a few months.
Fragmentation stage
Your child’s body then works to remove the dead part of the thigh bone and replace it with softer bone, leaving it in a weaker state. This makes the thigh bone joint prone to collapsing into a flatter position. On an X-ray, it might appear as though it’s in several pieces. This stage usually lasts one to two years.
Reconstitution stage (reossification)
This phase is often the longest and can last for several years. At this point, stronger bone tissue starts to form at the top of your child’s thigh bone. As the bone regains strength it will gradually take on a more normal, rounded shape.
Residual stage (healed)
By this stage, the bone regrowth is complete, and the top of the thigh bone will have formed its final shape. It may not be fully round again, depending on your child’s age and how much damage was caused by previous stages.
In early stages of Perthes’ disease, you might notice your child limping or changing the way they walk.
There are other symptoms to watch out for as the condition progresses. Your child might complain of pain or discomfort in their hip, groin, thigh or knee, either after physical activity or all the time. They may also experience muscle spasms.
If you’re concerned your child may have Perthes’ disease, get in touch with one our specialist consultants and make an appointment.
There are other symptoms to watch out for as the condition progresses. Your child might complain of pain or discomfort in their hip, groin, thigh or knee, either after physical activity or all the time. They may also experience muscle spasms.
If you’re concerned your child may have Perthes’ disease, get in touch with one our specialist consultants and make an appointment.
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PERTHES’ DISEASE DIAGNOSIS AT HCA UK
Fast diagnosis for your child
We understand how worrying it can be if you’re dealing with issues around your child’s mobility, or if they’re in pain. You can contact us to get an appointment with a surgical orthopaedic consultant, who’ll examine and begin diagnosing your child’s hip issue immediately and answer any questions you have. They may also measure your child’s thigh to check if they’ve lost muscle tissue.
Your consultant can order diagnostic tests or scans to help them get a more detailed picture of the issue too, including:
Your consultant can order diagnostic tests or scans to help them get a more detailed picture of the issue too, including:
- X-ray
- MRI scan
- An arthrogram
Our skilled teams have access to state-of-the-art diagnostic tools and can have results in as little as 48 hours.
PERTHES’ DISEASE TREATMENTS AT HCA UK
Effective, expert care
Perthes’ disease affects children in a variety of ways, ranging from mild stiffness and discomfort to significant mobility challenges. Some cases only need mild intervention, but severe cases may require more serious treatment, including surgery. In every case, your child’s wellbeing will be at the heart of our care.
Perthes’ disease has four distinct stages, so your child’s paediatric consultant will talk you through a variety of ways we can help your child manage their condition, depending on their age and the severity of the problem.
Some of the treatments they recommend may include:
Perthes’ disease has four distinct stages, so your child’s paediatric consultant will talk you through a variety of ways we can help your child manage their condition, depending on their age and the severity of the problem.
Some of the treatments they recommend may include:
- Physiotherapy
- A temporary plaster cast
- A special brace
- Crutches as mobility aids
- An osteotomy (see FAQs)
If your consultant thinks any surgical intervention is needed, they’ll discuss it with you in detail and answer any questions you may have.
Accessing private health care
Self-pay
You don’t need health insurance for your child to be seen quickly. If you’re looking for a diagnosis or treatment and don’t want to wait, all of our private healthcare services – from private GP appointments through to surgery and aftercare – can be paid for as and when you need them.
And we’ll give you a clear and transparent quote from the start, outlining exactly what’s included in your self-pay package.
FAQs
An osteotomy is a procedure that involves slightly cutting your child’s bone, in this case their hip joint, so it can be realigned with their hip socket. This can help to reduce pain and improve mobility.
Most children who get Perthes’ disease will find that the pain eventually settles down. Because the disease progresses in four distinct stages, it can be difficult to predict how long this might take.
If your child’s been more seriously affected, it’s possible they may develop significant hip problems later in life, and they may potentially need a hip replacement.
If your child’s been more seriously affected, it’s possible they may develop significant hip problems later in life, and they may potentially need a hip replacement.
This condition is considered very rare and only affects one in every 9,000-10,000 children, or fewer than 1% of the population. It is, however, four times more common in boys than girls, mainly affecting boys between the ages of 5 and 7 years old. Despite this higher ratio for boys, the condition is still considered rare for both genders.
If your child has the condition, they’ll need to attend regular appointments with a specialist so their hip can be closely monitored.
They may benefit from working with a physiotherapist to maximise the range of motion and hip strength, and from low-impact exercise such as cycling or swimming.
They may benefit from working with a physiotherapist to maximise the range of motion and hip strength, and from low-impact exercise such as cycling or swimming.
We don’t know why Perthes’ disease develops and it's not typically considered a hereditary condition. However, we do see a small number of cases in which several members of the same family develop it. This suggests that there is sometimes a genetic link between parent and child.
Thankfully, it’s extremely rare for the disease to recur. The long-term outlook for your child will depend on the degree of damage to their femoral head. Some children may develop osteoarthritis in the affected joint later in life. In rare cases, hip replacement surgery is required.
Our patients’ stories
Millie's story – still hula hooping after scoliosis surgery
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Rhiannon was an active 14-year-old girl. When she occasionally complained to her parents about aches and pains in her back, there was no reason to think it was anything more sinister than sore muscles from one of her dance classes, or something she’d pulled while horse riding.
Mimi’s story: Scoliosis surgery at 58 degrees
As 16-year-old Mimi climbed to the top of the giant Slitherine water slide in Dubai’s Atlantis aquaventure park, she had a momentary change of heart. Just three months before, the teenager from Walton on Thames, Surrey, had undergone major back surgery for scoliosis and started the difficult process of recovery. Seconds after her moment of doubt, she was plunging down the slide with her little sister, while their mum Tamara looked on.
Jack's Spinal Scoliosis story
Jack’s mother Jaime noticed his shoulder blades were slightly uneven in March 2020, at the start of the UK COVID-19 lockdown. After being faced with a long wait for a referral, a chance recommendation led Jaime to turn to The Portland Hospital. Here Jaime shares their story and explain why this surgery was so important.
“The whole team are lovely – and so great with children and teens.”
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This content is intended for general information only and does not replace the need for personal advice from a qualified health professional.