Pavone V, Chisari E, Vescio A, Lizzio C, Sessa G, Testa G. Aetiology of Legg-Calvé-Perthes disease: A systematic review. World J Orthop 2019; 10(3): 145-165 [PMID: 30918798 DOI: 10.5312/wjo.v10.i3.145]
Corresponding Author of This Article
Vito Pavone, MD, PhD, Associate Professor, Department of General Surgery and Medical Surgical Specialties, Section of Orthopaedics and Traumatology, University Hospital Policlinico-Vittorio Emanuele, University of Catania, Via Plebiscito 628, Catania 95100, Italy. vpavone@unict.it
Research Domain of This Article
Orthopedics
Article-Type of This Article
Systematic Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. Mar 18, 2019; 10(3): 145-165 Published online Mar 18, 2019. doi: 10.5312/wjo.v10.i3.145
Aetiology of Legg-Calvé-Perthes disease: A systematic review
Vito Pavone, Emanuele Chisari, Andrea Vescio, Claudio Lizzio, Giuseppe Sessa, Gianluca Testa
Vito Pavone, Emanuele Chisari, Andrea Vescio, Claudio Lizzio, Giuseppe Sessa, Gianluca Testa, Department of General Surgery and Medical Surgical Specialties, Section of Orthopaedics and Traumatology, University Hospital Policlinico-Vittorio Emanuele, University of Catania, Catania 95100, Italy
Author contributions: Pavone V, Chisari E and Testa G contributed equally to the work; Chisari E conceptualized and designed the review together with Vescio A and Testa G carried out the analysis; Lizzio C and Sessa G drafted the initial manuscript; All authors reviewed and approved the final manuscript as submitted.
Conflict-of-interest statement: All authors have no conflicts of interest to report.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Vito Pavone, MD, PhD, Associate Professor, Department of General Surgery and Medical Surgical Specialties, Section of Orthopaedics and Traumatology, University Hospital Policlinico-Vittorio Emanuele, University of Catania, Via Plebiscito 628, Catania 95100, Italy. vpavone@unict.it
Telephone: +3-909-53782273 Fax: +3-909-53782700
Received: November 2, 2018 Peer-review started: November 2, 2018 First decision: November 29, 2018 Revised: December 6, 2018 Accepted: January 10, 2019 Article in press: January 10, 2019 Published online: March 18, 2019 Processing time: 126 Days and 16.9 Hours
ARTICLE HIGHLIGHTS
Research background
Legg-Calvé-Perthes disease (LCPD) is a complex disease with a multifactorial aetiology. The etiopathogenesis of the disease was widely investigated in the last 20 years, but it is still unknown.
Research motivation
Numerous studies tried to explain the major actors in LCPD aetiology, but there is a lack of synthesis of the evidence.
Research objectives
The purpose of the study was to summarize the current evidence on the aetiology of LCPD.
Research methods
Two databases (PubMed and Science Direct) were systematically searched for relevant articles by two independent reviewers from their date of inception to the 20th of May 2018. Every step of the review was done according to PRISMA guidelines. Due to article heterogeneity and the topic after data analysis, a descriptive (synthesis) analysis was performed.
Research results
Sixty-four articles were included in this systematic review after applying our inclusion and exclusion criteria. Available evidence on LCPD aetiology is still inconclusive. Several hypotheses have been researched but none of them was found decisive.
Research conclusions
After our systematic review of the available evidence we conclude that LCPD aetiology relies on a multifactorial basis where environment in genetically predisposed patients participates in the pathogenesis of the disease.
Research perspectives
Further clinical and preclinical studies are strongly encouraged to understand better the mechanical and vascular basis of the etiopathogenesis of the disease. Interesting perspectives from studies on Leptin, obesity, and mechanical trauma were found and should be further investigated.
