Necrosis of the Femoral Head



by Akif Demirel, DVM

This condition is also known as Legg-Calve-Perthes Disease, Legg-Perthes disease, Perthes disease, coxa plana, and aseptic or avascular necrosis of the femoral head.

What is the condition?
The hip is a ball and socket joint of the hip. Necrosis or death of the femoral head means that the ball part of the joint is no longer properly functioning. This is due to loss of the blood supply to the femoral head. This may result from a growth abnormality or trauma.

What causes the condition?
It is a hereditary condition of small breed young dogs, especially terriers. It may also occur after trauma or injury to the leg or hip.

How is it diagnosed?
Usually slowly increasing lameness and inability to bear weight are the main clinical signs. It may begin in one leg and progress to both legs, especially in young pets. On clinical examination there is usually reduced hip joint movement, lack of muscle mass and apparent limb shortening. Owners often report that their pet has become increasing irritable. The diagnosis is made by taking x-rays of the hips.

What is the treatment?
The treatment of choice is femoral head and neck ostectomy (FHO) or removal of the femoral head and neck. Because the condition often affects young, small breed dogs, it is often unnecessary to replace the hip joint. Larger dogs with Legg-Calve-Perthes disease may require a total hip replacement.

What happens to the joint if part of the hip is removed?
Healing involves the laying down of fibrous tissue and in a very short time a false joint is created. Within months, most dogs are running and playing as if nothing happened.

Do complications occur?
Complications are rare following this type of surgery. A small percentage of dogs will always experience some limping or discomfort and require long term anti-inflammatory medication. Others will require a second surgery to remove any residual bone that may cause discomfort.

Will I be able to breed my dog?
Since this is often a hereditary condition, we do not recommend breeding any dog diagnosed with Legg-Calve-Perthes disease.

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