TY - JOUR
T1 - Total joint arthroplasty in a patient with osteopetrosis
T2 - 10-year follow-up
AU - Wang, Junwen
AU - Liang, Yuanxin
AU - Zhang, Qingsong
AU - Jiao, Jing
AU - Kan, Wusheng
PY - 2010/4/1
Y1 - 2010/4/1
N2 - Total joint arthroplasty may be considered as a last option to treat osteopetrosis associated with osteoarthritis. However, many intraoperative and postoperative challenges need to be overcome when performing arthroplasty in patients with osteopetrosis, and few studies have focused on the longer-term outcomes. This article describes a case of a 22-year-old woman with osteopetrosis who presented with osteoarthritis and underwent right total hip arthroplasty 10 years prior. A smaller and shorter femoral component was chosen for the patient, special tungsten steel drill bits were used to create the femoral canal, and the drilling process was under fluoroscopic guidance. In the second postoperative week, her Harris Hip Score increased to 82.15 points from 40.25 points preoperatively. No postoperative complications were seen, and radiographs illustrated the components were in good position. At 10-year follow-up, her Harris Hip Score was still 82 points, the components were in good position radiographically, and the patient could walk freely and perform activities of daily living with no pain. The success of the treatment lies in suitable selection of prosthesis components, extra caution during surgery, adequate perioperative antibiotic administration, postoperative functional exercise, and a low-calcium diet. Osteopetrosis is a rare inherited disorder first described in 1904 by Albers-Schonberg,1 characterized by defective osteoclast resorption leading to universally hard but brittle bone.2 The condition is conventionally subclassified into malignant, intermediate, and benign types, and the benign type is the most common clinical type, with an estimated incidence of 1:20,000 for the autosomal dominant form and 1:250,000 for the antosomal recessive form.3 Patients with the benign type of osteopetrosis have more chances to visit the orthopedic surgeon because of its long lifespan and many complications (eg, osteoarthritis, frequent fractures, coxa vara, long-bone bowing, osteomyelitis, and fracture nonunion).4 Among these problems, osteoarthritis could be recalcitrant to pharmacologic treatments, and total joint arthroplasty may be considered as a last option. However, the hard brittle bone and obliteration of the medullary canal could make arthroplasty implantation difficult, compromise the outcome, and lead to more frequent complications. Little information exists on the long-term outcomes of osteopetrosis patients who experienced arthroplasty. This article presents a case of arthroplasty for an osteopetrosis patient with 10-year follow-up.
AB - Total joint arthroplasty may be considered as a last option to treat osteopetrosis associated with osteoarthritis. However, many intraoperative and postoperative challenges need to be overcome when performing arthroplasty in patients with osteopetrosis, and few studies have focused on the longer-term outcomes. This article describes a case of a 22-year-old woman with osteopetrosis who presented with osteoarthritis and underwent right total hip arthroplasty 10 years prior. A smaller and shorter femoral component was chosen for the patient, special tungsten steel drill bits were used to create the femoral canal, and the drilling process was under fluoroscopic guidance. In the second postoperative week, her Harris Hip Score increased to 82.15 points from 40.25 points preoperatively. No postoperative complications were seen, and radiographs illustrated the components were in good position. At 10-year follow-up, her Harris Hip Score was still 82 points, the components were in good position radiographically, and the patient could walk freely and perform activities of daily living with no pain. The success of the treatment lies in suitable selection of prosthesis components, extra caution during surgery, adequate perioperative antibiotic administration, postoperative functional exercise, and a low-calcium diet. Osteopetrosis is a rare inherited disorder first described in 1904 by Albers-Schonberg,1 characterized by defective osteoclast resorption leading to universally hard but brittle bone.2 The condition is conventionally subclassified into malignant, intermediate, and benign types, and the benign type is the most common clinical type, with an estimated incidence of 1:20,000 for the autosomal dominant form and 1:250,000 for the antosomal recessive form.3 Patients with the benign type of osteopetrosis have more chances to visit the orthopedic surgeon because of its long lifespan and many complications (eg, osteoarthritis, frequent fractures, coxa vara, long-bone bowing, osteomyelitis, and fracture nonunion).4 Among these problems, osteoarthritis could be recalcitrant to pharmacologic treatments, and total joint arthroplasty may be considered as a last option. However, the hard brittle bone and obliteration of the medullary canal could make arthroplasty implantation difficult, compromise the outcome, and lead to more frequent complications. Little information exists on the long-term outcomes of osteopetrosis patients who experienced arthroplasty. This article presents a case of arthroplasty for an osteopetrosis patient with 10-year follow-up.
UR - http://www.scopus.com/inward/record.url?scp=77952873146&partnerID=8YFLogxK
U2 - 10.3928/01477447-20100225-23
DO - 10.3928/01477447-20100225-23
M3 - 文章
C2 - 20415306
AN - SCOPUS:77952873146
SN - 0147-7447
VL - 33
JO - Orthopedics
JF - Orthopedics
IS - 4
ER -