Legg-Calve-Perthes treatment options

Perthes disease changes over time as the femoral head loses blood supply, weakens, and then heals. The plan depends on the child’s age, pain, hip stiffness, imaging, and whether the ball remains well contained in the socket. The purpose is not simply to remove pain; maintaining hip movement and alignment can support the reshaping process.

A limp or knee pain can be an early presentation of a hip problem, but these symptoms do not establish the diagnosis. Assessment usually combines an examination with imaging and repeated review.

A clinician may advise limiting running, jumping, and contact activity while allowing comfortable low-impact movement. Pain relief, rest during flares, and exercises to preserve hip abduction and rotation may be included. Paediatric physiotherapy can make the exercise plan practical and monitor stiffness. Some children use a brace or traction for a period. If containment cannot be maintained, an osteotomy may realign the hip or thigh bone so the ball sits more securely.

Use crutches or other equipment only as instructed, and keep scheduled reviews even when walking looks better. A child should not be pushed through painful exercise.

Contact the treating team if pain, limping, stiffness, or reduced activity is worsening, or if a child stops bearing weight. Seek urgent assessment for sudden severe hip pain, inability to walk, fever with a painful joint, or an unwell appearance. These findings require examination because several hip conditions can present in similar ways.

Ask what activities are safe, which movements need daily practice, whether a brace or crutches are needed, and what imaging change would alter the plan. If surgery is discussed, ask what alignment it is intended to improve and how rehabilitation will be organised afterward.