Nonsurgical Treatment for Perthes Disease
Doctors at Hassenfeld Children's Hospital of New York at NYU Langone focus on identifying and treating Perthes disease in children before the ball of the hip joint, or femoral head, becomes misshapen. Nonsurgical treatments are often highly effective in helping a young child’s hip joint to heal properly. When started early, these treatments can also help to prevent long-term complications, such as arthritis.
Physical therapy is usually the first treatment for children with mild symptoms of Perthes disease and typically begins as soon as a child has been diagnosed. Physical therapy can help to restore range of motion in the hip joint, reduce inflammation and pain, and protect the joint as it heals.
Our physical therapists use a variety of exercises to increase range of motion in a child’s hip, improve muscle strength in the pelvis and legs, address problems with balance and walking, and prevent muscles and joints from stiffening. Depending on a child’s symptoms, these exercises may initially be performed a few times a week at NYU Langone’s Rusk Rehabilitation and then continued at home.
Occasionally, our doctors may recommend using a removable Petrie cast to keep the ball of the hip joint embedded in the socket as the joint heals. This rigid, fiberglass cast covers both legs from the hips to the ankles and has a bar connecting the legs, keeping them spread apart in the shape of the letter "A". The cast can be taken off temporarily for physical therapy.
A child with Perthes disease typically wears the cast full time for up to six months. Eventually, the cast is worn only at night.
Assistive devices, such as crutches, a walker, or a reclining wheelchair for traveling long distances, may be used to take pressure off of the hip and to prevent further injury to the joint. These devices are sometimes used in conjunction with physical therapy. Occupational therapists may also offer techniques and devices to help your child with dressing and grooming while he or she is in a cast.
Medications such as bisphosphonates may be recommended to help rebuild bone in children older than age six who have Perthes disease. Anti-inflammatory medications may also be prescribed to reduce inflammation in the joint or tissues surrounding the hip joint.
Our doctors may recommend a temporary restriction of activities such as sports while your child’s hip joint heals.