RT Journal
A1 Sponseller, Paul D.
T1 Commentary on an article by Harry K.W. Kim, MD, MSc, FRCSC, et al.: “How Much Varus Is Optimal with Proximal Femoral Osteotomy to Preserve the Femoral Head in Legg-Calvé-Perthes Disease?”
JF The Journal of Bone & Joint Surgery
JO The Journal of Bone & Joint Surgery
YR 2011
FD February 16
VO 93
IS 4
SP e14 1
OP 2
DO 10.2106/JBJS.J.01725
UL http://dx.doi.org/10.2106/JBJS.J.01725
AB 
Few disorders in pediatric orthopaedics are as confusing for families and physicians as Legg-Calvé-Perthes disease, which is diagnosed by exclusion and has an unknown etiology. Its symptoms wax and wane. In some patients, the hip heals well after a few years, yet other young adults develop early hip degeneration. Some of our treatments may not help. Much of our knowledge about this condition has come from Texas Scottish Rite Hospital for Children and from Dr. Harry Kim. This group has contributed an understanding of the biology of the disorder—that it is characterized by early predominance of bone resorption with delayed reossification. Texas Scottish Rite Hospital for Children has also led the way in the study of the clinical aspects of Legg-Calvé-Perthes disease with their two-decade-long, surgeon-randomized, prospective treatment study (a subset of which is the focus of this article)1. The current state of our clinical research and practice is to restrict active treatment to those children who really need it and to avoid unwanted effects of our surgical treatment. The article by Kim and coauthors in this issue of The Journal fills in another piece of the puzzle.