Consultant, Orthopaedics & Joint Replacement, Artemis Hospital, Gurgaon
Part 5 of 12 in Spectrum of Orthopaedic Disorder - Evaluation and Management
Perthes Disease: When Childhood Hip Damage Surfaces Years Later
September 6, 2026
Perthes disease develops in childhood, typically around eight to ten years of age, when the blood supply to the hip bone is damaged. Its effects do not always show up immediately: Dr. Lamba's Jivo Masterclass session included a patient who had lived with the consequences for years before surgery became necessary.
A case eight years in the making
The patient in question was eighteen years old but had been struggling with the condition for eight years, unable to walk normally in that time. The damage from childhood Perthes disease had progressed to a degree that required a hip replacement.
What the surgery restored
After the operation, Dr. Lamba described the patient's recovery in specific, functional terms rather than in vague terms of pain relief: he could sit cross-legged, squat, and sit down to offer prayers in the position his culture required, movements that reliably signal a genuinely well-restored hip in this patient population.
This article is based on a Jivo Masterclass session conducted by Dr. Rohit Lamba, Consultant, Orthopaedics & Joint Replacement, Artemis Hospital, Gurgaon. The article has been summarised with the assistance of an AI tool from the original masterclass recording. Watch the full Masterclass recording
This guide is based on a live Jivo Masterclass: Dr. Rohit Lamba taught doctors across Africa on April 6, 2025.
FROM THE LIVE Q&A
Moderator
Which group of patients is hip replacement surgery indicated for?
Dr. Rohit Lamba
Dr. Lamba outlined four categories. The first is congenital deformity, such as developmental dysplasia of the hip, where the hip is out of the socket from birth. The second is a childhood infection, Perthes disease, or a slipped epiphysis that reshapes the hip and leads to arthritis later in life. The third is avascular necrosis that has reached an advanced, arthritic stage in early adulthood. The fourth is a hip fracture that has not united properly, healing in a poor position that causes arthritis and pain.
Frequently Asked Questions
Is there a definitive treatment for arthritis?▼
Dr. Lamba answered on the assumption the question was about rheumatoid arthritis, since a network issue had cut off part of the question. In the early stage, before the cartilage is damaged, it can be managed well with disease-modifying antirheumatic drugs (DMARDs); cases that do not respond well can move to biological disease-modifying drugs, but only after full evaluation by an orthopaedic surgeon or rheumatologist. Once the cartilage is already damaged, the definitive treatment is hip replacement, and with current implants a patient can expect to stay pain-free and active for the next 30 to 35 years.
Which group of patients is hip replacement surgery indicated for?▼
Dr. Lamba outlined four categories. The first is congenital deformity, such as developmental dysplasia of the hip, where the hip is out of the socket from birth. The second is a childhood infection, Perthes disease, or a slipped epiphysis that reshapes the hip and leads to arthritis later in life. The third is avascular necrosis that has reached an advanced, arthritic stage in early adulthood. The fourth is a hip fracture that has not united properly, healing in a poor position that causes arthritis and pain.
What is Perthes disease?▼
It is a childhood hip condition, typically arising around eight to ten years of age, caused by damage to the blood supply of the hip bone.
Can untreated Perthes disease still be treated years later?▼
Yes. Dr. Lamba's patient had lived with the condition for eight years before a hip replacement, at age eighteen, restored his ability to walk.
What functional outcomes indicate a successful hip replacement in this context?▼
Dr. Lamba pointed to the patient's ability to sit cross-legged, squat, and sit down to pray as signs of a genuinely well-restored hip.
In This Series: Spectrum of Orthopaedic Disorder - Evaluation and Management
- 1.Spectrum of Orthopaedic Disorders
- 2.Understanding the Main Causes of Knee Arthritis
- 3.How Robotic and Computer-Navigated Systems Are Used in Joint Replacement
- 4.Developmental Dysplasia of the Hip: Treating a Childhood Hip Problem
- 5.Perthes Disease: When Childhood Hip Damage Surfaces Years Later
- 6.Avascular Necrosis of the Hip: Causes, Stages and Treatment
- 7.Hip Replacement and Sickle Cell Disease: Why Blood Transfusion Comes First
- 8.When Is Hip Replacement the Right Treatment?
- 9.ACL and Ligament Reconstruction: Grafts and When Surgery Is Needed
- 10.Treating Fracture Non-Union and Bone Infection with External Fixators
- 11.Reconstructing Severe Trauma: Distraction Osteogenesis for Bone and Limb Loss
- 12.Vitamin D Deficiency in Children: When Rickets Requires Corrective Knee Surgery