radiopaedia.org/articles/perthes-disease
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Children with over 50% of femoral head necrosis at time of diagnosis should be considered for operative management 1
As the disease progresses, fragmentation and destruction of the femoral head occur. In this situation, operative management is sometimes required to either ensure appropriate coverage of the femoral head by the acetabulum or to replace the femoral head in adult life.
Bracing may be used in milder cases, although femoral neck and acetabular osteotomies may be required to correct more severe abnormal femoroacetabular malalignment. In later life, hip replacements may be necessary 9.
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