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The Journal of Bone and Joint Surgery 79:1114-5 (1997)
© 1997 The Journal of Bone and Joint Surgery, Inc.

Correspondence

Correspondence

William A. Herndon, M.D, C. J. Glueck, M.D., Richard Freiberg, M.D., Alvin Crawford, M.D., Dennis Roy, M.D. and Davis Stroop, M.S.

TO THE EDITOR:

The article, "Association of Antithrombotic Factor Deficiencies and Hypofibrinolysis with Legg-Perthes Disease" (78-A: 3–13, Jan. 1996), by Glueck et al., was excellent. My only concern is their conclusion "when Legg-Perthes disease develops in a child, the levels of protein C, protein S, and lipoprotein(a); plasminogen activator-inhibitor activity; and stimulated tissue-plasminogen activator activity should be measured." I do not see a basis for this conclusion. The authors did not say what to do if those levels are abnormal. Their statement that "early diagnosis of protein-C or S deficiency, hypofibrinolysis, or a high level of lipoprotein(a) in such children may open avenues for pharmacological preventive therapy to reduce thrombophilia, stimulate fibrinolysis, or lower the level of lipoprotein(a), potentially ameliorating the Legg-Perthes disease process" may be true. However, the authors did not address therapy, and there was no scientific basis for their concluding statements. Unless the authors have information that . . . [Full Text of this Article]


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