Non-surgical treatment of Perthes disease.

Abstract

Introduction: Legg-Calve-Perthes disease (LCPD) is a self-limiting syndrome manifested as avascular necrosis of the femoral epiphysis in children aged 4 to 12, being more prevalent in boys. The non-surgical treatment of LCPD aims to prevent long-term sequelae, such as osteoarthritis, by reviewing strategies to ensure maximum functional benefits. Objective: This study reviews the non-surgical treatment of LCPD, evaluating its effectiveness and applicability. Methodology: The methodology of this review included a detailed analysis of recent scientific literature (2015-2024) relevant to the conservative treatment of LCPD, using databases such as PubMed and Scopus. Results: The findings emphasize physiotherapy, specifically active and passive stretching, as crucial for maintaining hip range of motion and preventing femoral deformity. Strengthening and balance exercises, facilitated in aquatic environments, help improve stability and joint coordination. Additionally, the use of walking aids, along with activity modification to reduce joint impact, is fundamental. Discussion: Non-surgical methods are comparable to surgical interventions in early stages, highlighting aquatic therapy for its ability to improve mobility without significant pain. However, the use of orthotics and adherence to treatment can be challenging, especially in advanced stages. Conclusion: Although surgical treatments are essential in advanced severity, conservative methods offer adequate joint stabilization and pain reduction in young patients. Continuous observation and therapeutic adjustments are essential to maximize benefits.