Our studies are organized based on the age at onset of Perthes as the treatment options and the question on how to best treat patients vary depending on the age at onset of the disease. Currently, we are researching treatments for three different age groups: age 6 to 8, 8 to 11, and over age 11. Note that we do not have a study for age less than 6 years since it is generally agreed that most patients (about 80%) in this age group tend to have a good outcome (defined as having a normal or close to normal femoral head) even without a surgical treatment.
Studies In-Progress for Early Stage of Perthes
- Study of 6 to 8 age group comparing non-surgical and surgical treatments
Study question: Do surgical treatments produce better outcomes at 2 and 5 years after treatment than non-surgical treatments?
Reason for the study: Both surgical and non-surgical treatments are used to treat patients with Perthes symptoms that start between age 6 and 8. However, we do not know if one form of treatment is better than the other so we proposed this study to examine these treatment outcomes.
- Study of 8 to 11 age group assessing the role of non-weight bearing after hip surgery
Study question: Does a longer duration of non-weight bearing after hip surgery (using crutches and wheelchair for 6 months compared to 6 weeks) make a difference to the femoral head shape and outcome at 2 and 5 years?
Reason for the study: Some doctors recommend 6 weeks of non-weight bearing after hip surgery whereas some doctors recommend 6 months or more. This study will determine if the duration of non-weight bearing makes a difference.
- Study of over 11 age group comparing 3 surgical treatments: multiple epiphyseal drilling vs multiple epiphyseal drilling followed by arthrodiastasis vs non-surgical management
Study question: Which of the three treatments produce better femoral head shape and functional results at 2 and 5 years?
Reason for the study: Patients who develop Perthes at this age tend to have poor outcomes (defined as having significant femoral head deformity and a higher risk of early arthritis) even with surgery. This study will compare the radiographic and functional outcomes of patients treated with a nonoperative treatment to one of the newer treatment approaches for late-onset Perthes disease: multiple epiphyseal drilling with 6 months of non-weight bearing or multiple epiphyseal drilling with hip distraction using an external fixator.
- Study of the prognostic value of advanced MRI called perfusion MRI on predicting outcome
Study question: Can perfusion MRI provide early information about how well the patient will do?
Reason for the study: While X-rays provide useful information, they do not provide reliable prognostic information at the early stage of Perthes disease which can sometimes lead to a delay in surgical treatment. This study will assess whether certain measurements obtained using a perfusion MRI can predict the patient's outcome and thus be used to make treatment decisions