Non-Surgical treatments includes:
Observation: For very young children (those 2 to 6 years old) who show few changes in the femoral head on their initial x-rays, the recommended treatment is usually simple observation. A doctor will regularly monitor the child using x-rays to ensure the the regrowth of the femoral head is on track as the disease runs its course.
Anti-inflammatory medications: Painful symptoms are caused by inflammation of the hip joint. Anti-inflammatory medicines, such as ibuprofen, are used to reduce inflammation and a doctor may recommend them for several months. As the child progresses through the disease stages, a doctor will often adjust or discontinue dosages.
Limiting activity: Avoiding high impact activities, such as running and jumping, will help relieve pain and protect the femoral head. A doctor may also recommend crutches or a walker to prevent the child from putting too much weight on the joint.
Your doctor may recommend surgery to re-establish the proper alignment of the bones of the hip and to keep the head of the femur deep within the acetabulum until healing is complete. Surgery is most often recommended when:
- The child is older than age 8 at the time of diagnosis. Because the potential for deformity during the reossification stage is greater in older children, preventing damage to femoral head is critical.
- More than 50% of the femoral head is damaged. Keeping the femoral head within the rounded acetabulum may help the bone grow into a functional shape.
- Nonsurgical treatment has not kept the hip in correct position for healing.
The most common surgical procedure for treating Perthes disease is an osteotomy. In this type of procedure, the bone is cut and repositioned to keep the femoral head snug within the acetabulum. This alignment is kept in place with screws and plates, which will then be removed after healing.