We have agreed to let our child have surgery for Perthes hip disease. It has been explained to us by the surgeon that this is the only way the hip can recover fully. But my concern is if the problem is caused by a loss of blood to the hip, doesn’t surgery put the hip at even more risk if something goes wrong? The surgeon said complications include nerve damage, nicking a blood vessel, infection, and a bunch of other things.

With any surgery (no matter how simple, minor, or complex), there are always potential problems or “complications.” It is the surgeon’s responsibility to make sure the patient or patient’s family is fully informed of these possibilities. The fact is that complications do occur but the majority of patients come through surgery just fine without any adverse effects.

Thanks to the wonderful benefits of MRIs, surgeons now have a map of the location, number, and pathway of blood vessels in the hips of children with Perthes disease. The blood supply to this area of the hip is called the vascular safe zone. Knowing where this vascular safe zone is located allows the surgeon to avoid disrupting it when surgically dislocating the child’s hip.

In a recent study from Children’s Hospital in Boston, surgeons found that children with Perthes disease who had surgery to correct the problem had fewer blood vessels compared with children who had a similar surgical procedure for developmental hip dysplasia. Most of the blood vessels in the children with Perthes disease inserted into the femoral neck through a very narrow pathway.

Operating within the vascular safe zone (and avoiding further disrupting the arteries bringing blood to the femoral head) when performing a surgical dislocation to correct the hip problem is important in preventing additional problems. Careful planning is required for this type of reconstructive surgery, including knowing where the vascular safe zone is located. With this knowledge, your surgeon will be able to minimize the risk of bleeding during the procedure.