IMPACTS OF PERTHES DISEASE

IMPACTS

SHORT TERM IMPACTS

Perthes Disease is a disease that can impact a great deal on the physical side of an individuals life. During breakdown and regrowth many restrictions are put in place, especially when it comes to physical activity. High impact activities which can impact on the hip joint such as running or jumping should be avoided, while low impact activities are encouraged such as swimming, bike riding and therapeutic horse riding.

During the breakdown of Perthes individuals can experience:
• Problems with walking
• Wasting of the muscles in the upper thigh
• Restriction of hip movement and stiffness of the hip
• Development of persistent pain
• Leg length discrepancy due to the involvement of a growth plate
• Impact of lower spinal chord, leading to back pain
• Drop in pelvis on unaffected side, causing gait or limp

These can persist long term and may be present for the childs whole life.

Some children will need to be hospitalised, and this can be severly impacting on their schooling and home life, especially in older children. in less severe ways due to surgery, rehabilitation and the use of wheelchairs and crutches. In the case of surgery, children won’t be able to weight bear for a minimum of six weeks and due to the blood loss experience will tired easily, taking up to two months to replenish blood cells to pre-operative levels.

LONG TERM IMPACTS

With regard to long term impact of Perthes disease a key finding regarding osteoarthritis and hip replacement is that the more the severe the case the, the greater the chance of arthritis. A key finding regarding long term impacts is that by the age of 30, a third of those affected will have no symptoms, a third will have intermitted hip inflammation and pain, and a third will have developed arthritis requiring treatment, in most cases a hip replacement. This degenerative arthritis depends on two factors:

The condition of the reshaped femoral head, the better the reshaped head, the better the outcome.
How well the ball fits in the socket, the better the fit, the better the outcome.

In general it can be seen that all Perthes sufferers will have an increased risk of osteoarthritis in their affected hip, and 50-60% of patients will eventually have evidence of arthritis or undergo a hip replacement.

PHYSICAL IMPACTS

IMPACT ON THE CHILD

Psychologically Perthes does have an impact on the individual that is coping with this condition.

Having such a physically impacting disease can cause a great deal of frustration and anxiety. The physical restrictions are hard to deal with and the inability to lead the same active lifestyle as friends and family can have a large impact on any individual. In this situation, especially children who don’t have as greater understanding of what is occurring can cause them to feel frustrated, anxious, distressed, isolated or different from the peers, especially when other peers or siblings are achieving higher than you. It can also impact later in life, when the long term impacts stop individuals from participating in activities with family members or friends, this inability to join in can be depressing.

When talking to psychologist Dr. Oborn regarding a possible explanation for the psychological impacts of Perthes Disease, he described possible reasons behind the feelings felt by some children suffering from Perthes. When suffering from such a disease he pointed out that it is possible for broader psychological consequences to emerge as an increasing gap develops between the child and his/her peers. Causing the child to feel that either they do not fit into the world of their peers or are subject to their own awareness that they are different in unwelcome ways in their own perceptions. Due to this it is possible to appreciate that there are ramifications due to this which can affect the child’s evolving personality. This can possibly affect all the basic psychosocial capacities necessary for normal function. It is widely known that disability affects a disabled person from the very different development of senses such as proprioception and development of behavioural skills and therefore it is highly possible that Perthes will have some form of psychological impact on a sufferer.

It is also interesting to not that the pain experienced during Perthes may also impact psychologically on the sufferer, however people handle pain in different ways. Therefore some sufferers will allow the pain to cause a negative impact, while other individuals won’t let the pain affect them. The individuals perception of pain is the greatest impact in this regard.

IMPACT ON FAMILY

Having a child with such a disability can be stressful and a great deal of hard work. It can put a great deal of strain on families, especially in regard to treatment expenses and the time allocated to care for your child. Recovery is a long and slow process, by having a family who are understanding, reassuring and supportive, provides the best environment for the child to come to term and hopefully overcome these feelings. It is important to stay positive and strong throughout your child's treatment.

PSYCHOLOGICAL IMPACTS