Die Literatur zum Morbus Perthes ist umfangreich. Eine Recherche bei PubMed für „perthes disease“ ergibt 2552 Treffer (Sept. 2020). Versuch einer Auswahl.

Calvé J. Sur une forme particulière de pseudo-coxalgie greffée sur des déformations caractéristiques de l’extrémité supérieure du fémur. Revue de chirurgie. 1910, 42:54–84.

Legg A. An obscure affection of the hip joint. Boston Medical and Surgical Journal. 1910, 162:202–204. Legg AT. An obscure affection of the hip joint. 1910. Clin Orthop Relat Res. 2006;451:11-13.

Perthes GC. Über Arthritis deformans juvenilis. Deutsche Zeitschrift für Chirurgie. 1910, 107:111–159.

Waldenström, H. Der obere tuberkulöse Collumherd. Zeitschrift für orthopädische Chirurgie 1909;XXIV:487-512


Canavese F, Dimeglio A. Perthes‘ disease: prognosis in children under six years of age. J Bone Joint Surg Br. 2008 Jul;90(7):940-5.

Caffey JP. The early roentgenographic changes in essential coxa plana: their significance in pathogenesis. Am J Roentgen 1968;103:620-34.

Catterall A. The natural history of Perthes‘ disease. J Bone Joint Surg Br. 1971;53(1):37‐53.

Catterall A. Legg-Calvé-Perthes syndrome. Clin Orthop Relat Res. 1981;(158):41‐52.

Catterall A. Legg-Calvé-Perthes‘ disease. Current problems in orthopaedics. Churchill Livingstone; Edinburgh, London, Melbourne, New York, 1982a.

Coates CJ, Paterson JM, Woods KR, Catterall A, Fixsen JA. Femoral osteotomy in Perthes‘ disease. Results at maturity. J Bone Joint Surg Br. 1990 Jul;72(4):581-5.

Joseph B, Varghese G, Mulpuri K, Narasimha Rao K, Nair NS. Natural evolution of Perthes disease: a study of 610 children under 12 years of age at disease onset. J Pediatr Orthop. 2003;23(5):590‐600.

Lloyd-Roberts GC. The management of Perthes‘ disease. J Bone Joint Surg Br. 1982;64(1):1-2.

Soeur S, De Racker Ch. L’aspect anatomopathologique de l’ostéochondrite et les théories pathogéniques qui s’y rapportent. Acta Orthopaedica Belgica, 1952;18(2),57-102

Stanitski CL. Hip range of motion in Perthes‘ disease: comparison of pre-operative and intra-operative values. J Child Orthop. 2007 Mar;1(1):33-5.

Stulberg SD, Cooperman DR, Wallensten R. The natural history of Legg-Calvé-Perthes disease. J Bone Joint Surg Am. 1981;63(7):1095‐1108.

Waldenström, H. The definite Form of the Coxa Plana. Acta radiologica Vol. I. 1922;31:384-94.

Waldenström, H. On Coxa Plana. Osteochondritis deformans coxae iuvenilis. Legg’s disease. Maladie de Calvé.  Acta chir. Scandinav. 1923;55:577-90.

Modified Elizabethtown Classification

Canale ST, D’Anca AF, Cotler JM, Snedden HE. Elizabethtown, Pennsylvania. Innominate osteotomy in Legg-Calvé-Perthes disease. J Bone Joint Surg Am. 1972;54(1):25-40.

Joseph B, Varghese G, Mulpuri K, Narasimha Rao K, Nair NS. Natural evolution of Perthes disease: a study of 610 children under 12 years of age at disease onset. J Pediatr Orthop. 2003;23(5):590‐600.

Hyman JE, Trupia EP, Wright ML, et al. Interobserver and intraobserver reliability of the modified Waldenström classification system for staging of Legg-Calvé-Perthes disease. J Bone Joint Surg Am. 2015;97(8):643‐650.


Jonsäter S. Coxa plana: a histo-pathologic and arthrographic study. Acta Orthop. Scand., Suppl. 12, 1953.

Larsen EH & Reimann I (1973) Calvé Perthes Disease: With special reference to histological observations, Acta Orthopaedica Scandinavica, 44:4-5, 426-438.

Catterall A, Pringle J, Byers PD, et al. A review of the morphology of Perthes‘ disease. J Bone Joint Surg Br. 1982;64(3):269-275.

Catterall A, Pringle J, Byers PD, Fulford GE, Kemp HB. Perthes‘ disease: is the epiphysial infarction complete?. J Bone Joint Surg Br. 1982;64(3):276-281.

Catterall A. Legg-Calvé-Perthes‘ disease. Current problems in orthopaedics. Churchill Livingstone; Edinburgh, London, Melbourne, New York, 1982a.

Kim HK. Pathophysiology and new strategies for the treatment of Legg-Calvé-Perthes disease. J Bone Joint Surg Am. 2012 Apr 4;94(7):659-69.

MRT – Magnetresonanztomographie, Kernspintomographie

de Sanctis N, Rega AN, Rondinella F. Prognostic evaluation of Legg-Calvé-Perthes disease by MRI. Part I: the role of physeal involvement. J Pediatr Orthop. 2000 Jul-Aug;20(4):455-62.

de Sanctis N, Rondinella F. Prognostic evaluation of Legg-Calvé-Perthes disease by MRI. Part II: pathomorphogenesis and new classification. J Pediatr Orthop. 2000 Jul-Aug;20(4):463-70.

Dillman JR, Hernandez RJ. MRI of Legg-Calve-Perthes disease. AJR Am J Roentgenol. 2009 Nov;193(5):1394-407.

Neuere Arbeiten

Kim HK, Aruwajoye O, Stetler J, Stall A. Effects of non-weight-bearing on the immature femoral head following ischemic osteonecrosis: an experimental investigation in immature pigs. J Bone Joint Surg Am. 2012;94:2228-37.

Kim HK, Burgess J, Thoveson A, Gudmundsson P, Dempsey M, Jo CH. Assessment of Femoral Head Revascularization in Legg-Calvé-Perthes Disease Using Serial Perfusion MRI. J Bone Joint Surg Am. 2016;98(22):1897-1904.

Aruwajoye OO, Monte F, Kim A, Kim HKW. A Comparison of Transphyseal Neck-Head Tunneling and Multiple Epiphyseal Drilling on Femoral Head Healing Following Ischemic Osteonecrosis: An Experimental Investigation in Immature Pigs [published online ahead of print, 2018 Jul 2]. J Pediatr Orthop. 2018;10.1097.

Laine JC, Martin BD, Novotny SA, Kelly DM. Role of Advanced Imaging in the Diagnosis and Management of Active Legg-Calvé-Perthes Disease. J Am Acad Orthop Surg. 2018;26(15):526‐536.

Laine JC, Novotny SA, Tis JE, et al. Demographics and Clinical Presentation of Early-Stage Legg-Calvé-Perthes Disease: A Prospective, Multicenter, International Study [published online ahead of print, 2020 Aug 27]. J Am Acad Orthop Surg. 2020;10.5435/JAAOS-D-19-00379.

Sankar WN, Laval SM, Mcguire MF, et al. Does Early Proximal Femoral Varus Osteotomy Shorten the Duration of Fragmentation in Perthes Disease? Lessons From a Prospective Multicenter Cohort. J Pediatr Orthop. 2020;40(5):e322‐e328.

Singh KA, Shah H, Joseph B, Aarvold A, Kim HKW. Evolution of Legg-Calvé-Perthes disease following proximal femoral varus osteotomy performed in the avascular necrosis stage: a prospective study. J Child Orthop. 2020;14(1):58‐67. 

Traina F, De Fine M, Sudanese A, Calderoni PP, Tassinari E, Toni A. Long-term results of total hip replacement in patients with Legg-Calvé-Perthes disease. J Bone Joint Surg Am. 2011;93(7):e25.

Eigene Arbeitsgruppe

Meiss L, Delling G. Stimulation of Bone Regeneration by Fragmented Cortical Bone and Porous Calcium Phosphate Ceramics (Tricalcium Phosphate and Hydroxyapatite) – An Experimental Study and Preliminary Clinical Results. Neuere Ergebnisse in der Osteologie, H.-G. Willert, F.H.W. Heuck (Hrsg.), Springer-Verlag, Heidelberg 1989, 619-31.

Meiss L, Schäfer B, Mallien O. Morbus Perthes – aggressives Zuwarten versus schonende Operation. „Kontroverses in der Kinderorthopädie“, Münsteraner Frühjahrs-Symposium, Mai 1994, I. Hofstätter / J. Jerosch, Verlag Shaker, Aachen, 1995.

Meiss L. Prognosis in Perthes‘ disease. J Bone Joint Surg Br. 1999;81(1):179‐180.

Meiss A L. MRT zur Diagnostik des Containment-Verlustes beim Morbus Perthes – MRI in the diagnosis of loss of containment in Perthes‘ disease. Medizinisch-Orthopädische Technik 2001;121:47-54.

Stuecker MH, Meiss AL. Monitoring of Containment in Perthes‘ Disease: Can Ultrasonography be Helpful?. Ortop Traumatol Rehabil. 2004;6(5):582‐588.

Stücker MH, Buthmann J, Meiss AL. Evaluation of hip containment in legg-calvé-perthes disease: a comparison of ultrasound and magnetic resonance imaging. Ultraschall Med. 2005;26(5):406-410.

Funk JF, Perka C, Pruss A, Meiss AL, Placzek R. Modifizierte Azetabuloplastik unter Verwendung von bioresorbierbaren Schrauben und lyophilisiertem allogenem Knochen [Modified acetabuloplasty using bioresorbable screws and lyophilised allogenic bone]. Z Orthop Unfall. 2008;146(6):720-724.

Meiss AL, Barvencik F, Babin K, Eggers-Stroeder G. Denosumab and surgery for the treatment of Perthes‘ disease in a 9-year-old boy: favorable course documented by comprehensive imaging- a case report. Acta Orthop. 2017;88(3):354‐357.

Dissertationen (Fachbereich Medizin der Universität Hamburg)

Frauke Lange. Zur Coxa magna cartilaginea in der Frühphase des Morbus Perthes: Ergebnisse kernspintomographischer Untersuchungen und ihre Wertung, Hamburg, 1997

Christian Gauck. Die konservative Therapie des Morbus Perthes: eine Evaluierung der entlastenden Schienenversorgung, Hamburg, 1997

Lars Clarfeld. Ein neuer Ansatz in der Behandlung des Morbus Perthes: Durchtrennung des Ligamentum transversum acetabuli; Ergebnisse einer Pilotstudie. Hamburg, 2003.

Sintje Singerhoff. MR-basierte Volumetrie des Hüftkopfes und der Hüftpfanne beim Morbus Perthes und einem Normalkollektiv. Hamburg, 2007.

Weblinks zur International Perthes Study Group (IPSG)

Modified Elizabethtown Classification-Cheatsheet Miscellaneous

Gute Übersicht zum Morbus Perthes auf Englisch vom JBJS, 2018

  • Pediatrics, Hip
    December 14, 2018
  • Legg-Calve-Perthes Disease
  • By: Paul D. Sponseller, MD
  • Perthes disease is the pediatric form of avascular necrosis of the femoral head. Compared to adult forms of the disorder, resorption and reossification are more pronounced. The femoral epiphysis is weakened during this process and may become flattened. Assessment of status and healing of the femoral head may be achieved with a serial perfusion MRI, requiring gadolinium administration and special software. This imaging technique demonstrated that revascularization of the femoral head in Perthes occurs in a “horseshoe” pattern, starting from posterior, medial, and lateral regions. Revascularization occurs at a variable rate, at a mean of 5% per month. This can help patients and their parents appreciate the long course of recovery from this condition.
    Traditional treatments for Perthes over the past half-century have focused on decreasing harmful pressure and maintaining symmetrical loading. These have had modest success. Because most patients are treated nonoperatively, it is useful to know that at 20 years of follow-up, nearly half of Perthes patients have moderate to severe osteoarthritis, especially those having a lateral column type B, B/C, or C, or those who heal with Stulberg grade 4 or 5 asphericity. Femoroacetabular impingement is also common.
    Femoral osteotomy can improve femoral head sphericity, but amounts of varus over 10° have not shown benefit. A meta-analysis of femoral and Iliac osteotomies has shown improved sphericity compared with nonoperative treatment in children older than 6 years of age. Osteotomies are most effective when performed before the advanced fragmentation phase. Combined femoral and iliac osteotomies do not provide improved results over historically published results of either osteotomy alone. Investigations into newer biological treatments aimed at decreasing resorption and increasing reossification are underway. These have promise to improve future outcomes.
    The results of eventual hip replacements in Perthes patients should be closely monitored, especially in the setting of osteotomies during childhood. A retrospective study reported a 96% hip-replacement survival rate at 15 years in young adults, though there was a 6% rate of permanent sciatic palsy.
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