Posted by Gary on February 27, 2004 at 10:28:41:
In Reply to: wont to know more posted by mrgaret gilmour on February 26, 2004 at 13:18:56:
Margaret, I'm not a physician and I know nothing about your son's Perthes so I can't tell you whether he "must" have major surgery. I can offer these observations:
If your son is still in an active phase of Perthes (fragmentation or regrowth) there are surgical procedures that can help contain the femur head (the ball) within the acetabulum (the socket) and both protect it and produce a better result than if the head is not contained. There are several procedures, including those that realign the head of the femur and those that reshape the pelvis, that have been effective.
If your son has completed the Perthes cycle and the femur head has regrown and is not contained, there are procedures like the shelf arthroplasty that can extend the socket and provide containment.
Before committing to any surgical procedure, you and your son should understand why the doctor wants to perform the surgery (what specifically needs to be corrected); what the surgery will specifically accomplish (how will it help the problem) and why the particular procedure is better than alternatives.
You don't say how long your son has had Perthes. Generally, children over the age of about nine do not do well with conservative treatment and surgery may be indicated. Your son's age is very high for Perthes and doing nothing is likely to result in a femur head that is not shaped like it should be. This situation may result in early onset of some form of osteoarthritis and could eventually lead to the need for hip replacemnt surgery.
The best advice I could offer is ask the doctor lots of questions then get a second opinion from a pediatric orthopedic specialist who has significant experience treating Perthes.