What are the treatment options for Perthes disease?

Perthes disease affects the blood supply to the developing ball of the hip. The bone may change shape while it heals, so treatment aims to preserve hip movement and keep the ball well positioned in its socket. Doctors use the child’s symptoms, examination and repeat imaging to follow the stage and shape of the hip.

Some children need observation with regular review; others need limits on impact activities, crutches or a brace. The choice depends on age, hip movement, involvement of the joint and how the condition is progressing.

Pain relief should follow the clinician’s advice. Swimming, cycling or other approved low-impact activities may maintain fitness while running and jumping are restricted. Paediatric physiotherapy can preserve hip range, strengthen surrounding muscles and teach safe home exercises without forcing painful movement.

If the hip is difficult to keep in a useful position, an orthopaedic team may recommend a brace or surgery. An osteotomy changes the alignment of the bone to improve containment of the hip during healing. Follow-up visits matter because the plan can change as the hip develops.

Contact the treating team if pain increases, a child begins limping more, hip movement becomes restricted, or prescribed exercises are consistently painful. Seek urgent assessment after an injury with inability to walk, severe pain, fever, or a hot and swollen joint. Keep activity within the limits given by the child’s orthopaedic clinician.

Which stage is my child in, and what does the imaging show? Which activities are safe now? Does my child need physiotherapy, a brace or crutches? What signs would make surgery, including osteotomy, worth considering? How often should follow-up imaging occur?