Pain physician
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Legg-Calvé-Perthes disease (LCPD) and slipped capital femoral epiphysis (SCFE) can result in painful deformation of the hip joint with impaired range of motion and early development of secondary osteoarthritis. It has not been investigated whether having LCPD or SCFE is associated with increased use of pain or antidepressant drug prescriptions later in life. ⋯ During childhood, patients with LCPD or SCFE seem to suffer long-term pain and have an increased risk of requiring analgesic medication in adulthood, including opioids. It is important to assess the causes, type, and severity of pain to optimize pain management to counteract possible overuse in these patients. Seemingly, patients with LCPD do not have an increased risk for antidepressant drug therapy in adulthood whereas we did see an increased risk for that in patients with previous SCFE compared with the general population.
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Recurrent LDH (rLDH) is one of the most common causes of unsatisfactory outcomes after discectomy, which usually needs secondary surgery and leads to physical and psychological suffering for patients and substantial costs for society. ⋯ This study demonstrated that the recurrence rate of LDH at 5-year follow-up was 6.27% and there was a significant statistical relationship between FO, DHI, and Modic changes and early rLDH. Surgeons should take FO angles, DHI, and Modic change into consideration before surgery to achieve a satisfactory postoperative outcome and a relatively lower early recurrence rate. More patients and further investigation should be taken to assess the risk factors for early rLDH.