1. The Norwegian Perthes Study
Terje Terjesen, Ola Wiig, Svein Svenningsen,
Stefan Huhnstock

2. The Norwegian Perthes Study

3. The Norwegian Perthes Study
Just for your orientation, it is located just behind this wall.

4. The Norwegian Perthes Study
Norwegian are know for their hospitality

5. The Norwegian Perthes Study
For great summers

6. The Norwegian Perthes Study
And foreigners love it for outdoor activities and climbing

7. The Norwegian Perthes Study
Multicenter study, including all Norwegian hospitals with orthopedic service.

8. The Norwegian Perthes Study
1996 – 2000
We registered all new Perthes cases through out a 4 years period.

9. The Norwegian Perthes Study
1996 – 2000
425 patients
76% male, 24% female
There were 425 patients registered. All patients were followed after diagnosis at 1 year, 3 year and 5-year follow-up. 3 out of 4 were boys, one fourth were girls.
We are currently planning a long term follow-up of these patients.

10. The Norwegian Perthes Study
1996 – 2000
425 patients
76% male, 24% female
13 % Scottish rite orthosis
61% Physiotherapy
26 % Surgery
The majority of the patients were treated non surgically, mainly with physiotherapy. About one fourth of the patients were treated with varus osteotomy of the femur.

11. Earlier this year I had the pleasure to get know some of the IPSG members a little bit better, since we had the honor to welcome them as POSNA travel fellows in our unit.

12. Just a month ago Harry visited Oslo and there we discussed if there may be a scientific potential in collaborating, combining the Norwegian group with the IPSG group.

13. “Wait to classify approach” vs. «treat as early as possible» approach
Perthes study
“Wait to classify approach” vs.
«treat as early as possible» approach
One idea we discussed, but there may be more than that of course, that it could be interesting to compare the surgical treated patients.

14. There was and probably is a tendency in Norway that treatment is initiated following the radiographic appearance in fragmentation phase. This has been termed in some literature as “ Wait to classify approach”. Others , especially my mentors would rather call it , we should know what to treat approach, but that’s another story.

15. MRI and particularly perfusion MRI allows for an earlier prediction of femoral head necrosis and treatment nowadays may be initiated earlier. And we thought that it may be of interest to see whether these two different approaches have a bearing on the outcome…

16. Age group 6- 8 years Gender Frequency Percent Valid male 159 74,3
female ,7
Total ,0
Bilateral affection
Frequency Percent
Valid unilateral ,3
bilat ,7
Total ,0

17. Age group 6- 8 years Lateral pillar classification
Frequency Percent Valid Percent
Valid A 16 7,5 8,4
B ,6 78,0
C ,1 13,6
Total ,3 100,0
Missing System ,7
Total ,0

18. Age group 6- 8 years Treatment Frequency Percent Valid Percent
Valid Physio ,1 48,4 operation ,0 35,2 brace ,4 16,4 Total ,5 100,0
Missing System 1 ,5
Total ,0

19. Age group 6- 8 years – surgical treated only
Gender
Frequency Percent Valid Percent
Valid male ,7 70,7 female ,3 29,3 Total ,0 100,0
Bilateral affection
Frequency Percent Valid Percent
Valid unilateral ,3 93,3
bilat ,7 6,7 Total ,0 100,0

20. Age group 6- 8 years – surgical treated only
Laterall pillar classification
Frequency Percent Valid Percent Cumulative Percent
Valid A 2 2,7 2,9 2,9
B 56 74,7 80,0 82,9
C 12 16,0 17,1 100,0
Total 70 93,3 100,0
Missing System 5 6,7
Total ,0