Perthes
Legg–Calvé–Perthes syndrome is a degenerative disease of the hip joint, where growth and/or loss of bone mass leads to some degree of collapse of the hip joint.
As a child I suffered from a disease called Perthes Disease. I spent four years in a wheelchair and then a year of rehabilitation to walk again. This was after I was told that I’d never walk or play football again. Perthes’ disease is a condition of the hip which occurs in some children (around 1 in every 20,000). It was first described in 1910 by three separate doctors and so gained the name Legg-Calve-Perthes, after each of these doctors.
About Perthes
The problem occurs in the femoral head. This is the rounded top of the femur (the thigh bone) which sits inside the acetabulum (the hip socket). Something happens to the small blood vessels which supply the femoral head with blood. So, parts of the femoral head lose their blood supply. As a result, the bone cells in the affected area die and so the bone ‘softens’, and can fracture, break up, and become distorted. The severity can vary depending on the time the disease is diagnosed and the response to the treatment. For me, I lost the entire femoral head of my ball joint.
It is not clear why this blood vessel problem occurs in the femoral head. It isn’t due to injury or to a general blood vessel problem. A child with Perthes disease is usually otherwise well. Over several months the blood vessels grow, and the blood supply returns to the ‘dead’ bone tissue. New bone tissue is then laid down and the femoral head re-grows and remodels over several years. This is similar to how bone reforms and remodels after any ‘normal’ fracture or break to a bone, but takes longer. As you can see in the diagram below, there is a major, catastrophic difference in the formation of the hip suffering from Perthes. In the x-ray, you can also see that the density in the bone is a lot different (a lot less dense), which also leads to the bone structure being weaker. When my femoral head grew back it did so in more of a triangle fashion instead of a sphere which restricts my movement now.
2006
In January 2006 I was diagnosed with complications of Perthes. After attending hospital over the past few years, the doctors have now determined that I have a problem a little more serious. I need to either have my hip replaced, the hip joint stiffened or a couple of other options which aren’t particularly pleasant enough to talk about. My doctors are currently giving me time to decide when to have my hip replaced which I’m pushing back as long as I can do. I want to live my life as normal as possible and taking each day as it comes.
I do hope that I can last a few more years before I’m forced into making that decision. Fast forward to now and you’ll notice that I do a lot of walking and visit a lot of places GeoCaching. I’m determined to be active and this is my passion while I can still walk normally.
2018 & 2019 Update
In the last year, the degeneration of my hip has increased rapidly. This is now being controlled by medication so I can’t feel quite as much but I need a hip replacement badly. I’ve been through the pre-operation consulting and signed all paperwork that is needed. Now I’m just waiting for the date to have a total hip replacement of my right hip.
It’s funny looking back higher in this page at 2006 when I’d hoped for a few more years out of my hip - I managed to get about an additional 12. I look forward to seeing what life is like pain-free even though it’s going to be a lot of work until I get there.
More Information
This is a small collection of the links that I have compiled so far. If you can find more references then please contact me and I will happily add them to this for others to find.