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Legg-Calvé-Perthes disease and the risk of injuries requiring hospitalization: a register study involving 2579 patients
Department of Orthopaedics, Uppsala University Hospital, Uppsala, Sweden.
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Clinical Epidemiology Unit, Department of Medicine, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden. (Clinical Epidemiology and Biostatistics)ORCID iD: 0000-0001-6328-5494
Clinical Epidemiology Unit, Department of Medicine, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden.
Department of Orthopaedics, Uppsala University Hospital, Uppsala, Sweden.
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2012 (English)In: Acta Orthopaedica, ISSN 1745-3674, E-ISSN 1745-3682, Vol. 83, no 6, p. 572-576Article in journal (Refereed) Published
Abstract [en]

Background and purpose: Previous studies have suggested that Legg-Calvé-Perthes disease (LCPD) is associated with repetitive trauma, coagulation problems and anatomical abnormalities of the blood supply to the femoral head. The hypothesis that repetitive trauma can affect the blood supply of the femoral head, leading to LCPD, is supported by an animal model. For evidence of an increased risk of repetitive trauma, we investigated whether patients with LCPD have a higher risk for severe injuries requiring hospitalization.

Patients and methods: We identified 2579 patients with LCPD in Sweden during the period 1964-2005. 13,748 individuals without LCPD were randomly selected from the Swedish general population, matched by year of birth, sex and region (control group). Cox proportional hazard regression estimated the risks.

Results: Compared to the control group, patients with LCPD had a modestly raised hazard ratio (HR) of 1.2 (95% CI 1.1-1.3) for injury requiring hospitalization. The risks were slightly higher for soft tissue injuries (HR = 1.3, 95% CI:1.1-1.4) than for fractures (HR = 1.1, 95% CI: 1.0-1.3) and more pronounced among females. Compared to the control group, the higher risk for injury only applied to the lower extremities (HR = 1.2, 95% CI: 1.0-1.4) in patients with LCPD.

Interpretation: Patients with LCPD are vulnerable to injuries which could be interpreted as a marker of hyperactive behavior. It could also implicate that anatomical changes in the bone formation or blood supply of the femoral head - increasing its sensibility for trauma - contribute to the etiology of LCPD.

Place, publisher, year, edition, pages
New York, USA: Informa Healthcare, 2012. Vol. 83, no 6, p. 572-576
National Category
Medical and Health Sciences Orthopaedics
Research subject
Medicine
Identifiers
URN: urn:nbn:se:oru:diva-27814DOI: 10.3109/17453674.2012.736167ISI: 000311679900005PubMedID: 23043293Scopus ID: 2-s2.0-84870272516OAI: oai:DiVA.org:oru-27814DiVA, id: diva2:608814
Available from: 2013-03-01 Created: 2013-03-01 Last updated: 2018-07-22Bibliographically approved

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Montgomery, Scott M.

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