Hip Pelvis.  2025 Mar;37(1):38-44. 10.5371/hp.2025.37.1.38.

Evaluation of the Influence of Changes in Bone Mineral Density and Increases in Articular Cartilage Thickness on Blood Supply of the Femoral Head in Legg–Calvé–Perthes Disease

• Farpour HR
• Karimi MT
• Karimi MH

• KMID: 2565618
• DOI: http://doi.org/10.5371/hp.2025.37.1.38

Abstract

Purpose
Although the etiology of Legg–Calvé–Perthes disease (LCPD) is not well understood, based on a new theory, it may be caused by a decrease in the supply of blood to the femoral head. The objective of this study was to examine the effects of a decrease in bone mineral density (BMD) and an increase in thickness of articular cartilage on the supply of blood to the femoral head in this group of patients.
Materials and Methods
This case study was based on a simulation analysis. Computed tomography scan images of a subject with Perthes disease were used to create a three-dimensional model of the hip joint on both the normal and Perthes sides. In addition, modeling of the blood vessels of the femoral head, including the foveolar and retinacular arteries, was performed during this study.
Results
Increased stress on all articular components (femoral head, acetabulum, articular cartilage, and blood vessels) was observed on the Perthes side compared to the normal side. On the Perthes side with normal articular cartilage thickness, stress on all components, particularly the femur, showed a significant increase compared to the normal side.
Conclusion
Increased deformation of the femoral head vessels was observed in patients with Perthes condition and when increased thickness of the articular cartilage was observed. A decrease in BMD can evidently increase the stress applied to the arteries of the femoral head, ultimately leading to death of the femoral head.

Keyword

Perthes; Bone deformation; Stress; Finite element analysis