Prognosis of Perthes' Disease - Calum Clark 16/1/2001
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Brief
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STULBERG JBJS (A) 1981
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Author
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Stulberg SD , Cooperman DR, Wallensten R (Chicago and Illinois)
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Title
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The Natural History of Legg-Calve-Perthes Disease
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Reference
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JBJS 1981; 63-A: 1095-1108
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Summary
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2 study groups: 1/ 99hips average 40 year F/U. Xrays at maturity grouped I to V on head size/shape, neck length, slope of cup, cover. Dec. function + inc. OA from classes I to V. 2/ 72 hips ' Catterall graded ' degree of subluxation predicts Stulberg class
except
class V. Is containment worthwhile?
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Critique
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Very important work. Multi-centre. Established accepted follow-up criteria universally used now. Usual problems of randomised study
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Brief
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ISMAIL + McNICHOL JBJS (B) 1998
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Author
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Ismail AM and MacNichol MF (Edinburgh)
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Title
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Prognosis in Perthes Disease a comparison of radiological predictors
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Reference
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JBJS 1998; 80-B: 310-314
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Summary
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Retrospective review over 30yrs' notes and XRs on 81 hips to maturity. Classified by arthrography, Herring, Catterall, Salter-Thompson + age. Stats showed best prediction of Stulberg score by combination of Herring grade, sphericity on arthrography and age (cut-off 7).
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Critique
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Retrospective, no mention of 'lost' group. Bias towards 'sphericity on arthrography'. End-point is not OA. Complex stats.
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