Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Maresch, I.
Das Hüft- Belastungsmoment als prognostischer Faktor bei PatientInnen mit Morbus Perthes
[ Diplomarbeit ] Medical University of Graz; 2013. pp. 75
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Linhart Wolfgang
- Svehlik Martin
- Altmetrics:
- Abstract:
- Introduction: Morbus Perthes is one of the most common hip diseases in childhood and the long-term outcome often affects the quality of life in a negative way. The aim of our study was to find out if the hip abductor moment during gait, as surrogate for loading of the hip joint, might be an important prognostic factor for the long-term radiological, functional and subjective outcome in Perthes disease. Methods: 42 children with Perthes disease, who underwent preoperative gait analysis between 1998 and 2003, were identified as potential candidates for the study. However, only 14 patients (11 males and 3 females) were willing to participate in our study. All patients underwent a clinical and radiological examination as well as kinematic and kinetic 3D gait analysis. The Gait Deviation Index (GDI) as a summary measure of gait pathology was calculated. Additionally, participants were asked to fill in Hip disability and osteoarthritis outcome score (HOOS) and the Harris hip score (HHS) was assessed. The Spearman¿s rank correlation coefficient was used to test our hypothesis. Results: There was no correlation between the hip abductor moment at the beginning of the disease and the long-term radiological outcome. The GDI neither correlates with the radiological outcome nor with any clinical parameter. The age at treatment is an important factor for the subjective outcome evaluated by the HHS and the HOOS. However, no correlation between the age and the radiological outcome was found. On the other hand preoperative radiological staging according to Herring classification was proved to be an important factor for the long-term radiological outcome. Patients with worse radiological outcome additionally described more symptoms and problems in sports activities, and limping was also more frequent. When Range of Motion (ROM) was limited, patients showed more limping and reported more symptoms and pain. Conclusion: As we only had a low number of participants in our study, we unfortunately were not able to confirm our hypothesis that the hip abductor moment during gait influences the radiological long- term outcome in LCPD. However, our study confirmed the important role of Herring classification for the radiologic prognosis as well as the role of age for long- term functional outcome in Perthes disease. Moreover, simple clinical measurements like hip ROM might be predictors for subjective symptoms, pain and limping. Future studies with larger number of participants and sufficient power are needed to show if loading of the hip might play an important role in long- term outcome of LCPD.