Published online Mar 18, 2019. doi: 10.5312/wjo.v10.i3.145
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
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.
Numerous studies tried to explain the major actors in LCPD aetiology, but there is a lack of synthesis of the evidence.
The purpose of the study was to summarize the current evidence on the aetiology of LCPD.
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.
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.
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.
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.