End-stage Posttraumatic Osteoarthritis Treated With THA in Osteogenesis Imperfecta

Abstract

Osteogenesis imperfecta is an incurable genetic disorder manifested with altered bone quality that predisposes patients to a multitude of fractures throughout their lives, including acetabular fractures. The management of acetabular fractures in patients with osteogenesis imperfecta remains a challenging clinical problem, with a paucity of literature supporting treatments and their outcomes. Limited reports in the literature validate the use of total hip arthroplasty (THA) in patients with osteogenesis imperfecta, and they describe the adult population only.This article describes a case of delayed diagnosis of a transverse acetabular fracture and femoral head impaction fracture that led to posttraumatic end-stage hip osteoarthritis in a 16-year-old boy with osteogenesis imperfecta (Sillence Type I) that was sustained after minimal trauma. Clinical examination 3 months postinjury revealed a significant pelvic obliquity, severe pain with hip range of motion, and limited hip range of motion. Imaging studies revealed a complete loss of articular cartilage and significant joint effusion.The patient underwent THA. No postoperative complications occurred. Two-year follow-up showed an excellent clinical result. The patient's hip was pain free, and he was able to walk with no limp.The authors are unaware of any reported cases of children with osteogenesis imperfecta undergoing THA. Based on the reported literature and the authors' experience, THA can be a reliable surgical option for patients with osteogenesis imperfecta.

Custom hemiarthroplasties for retention of existing hardware associated with osteogenesis imperfecta

“…Standard surgical techniques in the treatment of osteoarthritis can be technically challenging in this patient population because of the nature of their bone integrity and fragility. Extra care and preoperative planning has been effective when using custom components [10] and standard components [7], [13], [14] in the treatment of end-stage osteoarthritis in patients with osteogenesis imperfecta. However, no case has been described having been performed in the setting of existing hardware.…”

Hüftendoprothetik bei Deformitäten des proximalen Femurs

“…Bei der Osteogenesis imperfecta und anderen angeborenen Knochenerkrankungen sollte die Indikation zur endoprothetischen Versorgung äußerst zurückhal-tend gestellt werden, da chirurgische Revisionsoptionen höchst limitiert sind und die wenigen bisher publizierten Resultate primärer Hüftendoprothetik im Vergleich mit der Allgemeinbevölkerung ohne hereditäre Knochenerkrankungen schlechte Resultate erwarten lassen [10,22,35].…”

Osteoarthritis and Other Joint Involvement

“…25 Recently, Rousseau and colleagues looked at cartilage degradation in patients with OI as compared to subjects with OA and age-matched controls and the relationship between this and alterations of the mechanism of type I collagen. 26 Biochemical markers that were used to assess changes in bone and cartilage turnover were Helix-I and CTX-I for type I collagen for bone and CTX-II for cartilage.…”