Hybrid total hip arthroplasty for multiple epiphyseal dysplasia

Vanlommel, Jan; Vanlommel, Luc; Molenaers, Ben; Simon, Jean‐Pierre

doi:10.1016/j.otsr.2017.11.014

Cited by 9 publications

(6 citation statements)

References 29 publications

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“…There is currently no etiological therapy for this impairment, which reduces the treatment of patients to slowing down the progression of osteoarthritis through symptomatic therapy with the timely application of radical treatment methods in order to preserve the social adaptation of patients [5,6,9,10,[13][14][15]. But the presence of signs of epiphyseal dysplasia in patients with osteoarthritis of the joints of the limbs is quite often overlooked by practicing doctors, which disorients the prospects for the use of conservative treatment methods and leads to unjustified postponement of effective surgical intervention [12,[15][16][17][18][19][20].…”

Section: Introductionmentioning

confidence: 99%

Histological features of articular cartilage and bone marrow reparative potential under conditions of coxarthritis in patients with radiographic signs of epiphyseal dysplasia

Huzhevskyi,

Herasymenko,

Poluliakh

et al. 2023

OTP

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Coxarthritis in patients with radiographic signs of epiphyseal dysplasia causes disturbances of social adaptation of this patients group at a young age and ensure the relevance of studying the problem of optimizing the orthopaedic treatment of this patients category. Objective. To define the tactics of orthopaedic treatment in such patient category based on study of morphological features of articular cartilage and osteogenic activity of bone marrow stem stromal cells. Materials and Methods. We have clinically examined 68 adult patients having coxarthritis in the presence of radiological signs of epiphyseal dysplasia. In 52 cases we performed total hip and knee arthroplasty that allowed to obtain articular cartilage fragments for histological study and epiphysis bone fragments for study of reparative potential of the bone tissue. Results. In patients having coxarthritis that evolves on the ground of epiphyseal dysplasia by histological and cultural studies we have obtained the data as for deep microstructural disorders in joint cartilage matrix organization as a result of modification of collagen mesh in patients having epiphyseal dysplasia. We have identified the fact of significantly increased bone marrow stem cells proliferative potential at significantly decreased quantity of colony forming fibroblast units in spongious volume unit in epiphysis zone in this patients group which indicates a threat of decompensation of reparatory bone potential risk. Conclusions. Pathological factors of increasingly progressing course of osteoarthrosis in the presence of radiological signs of epiphyseal dysplasia are deep microstructural disorders of joint cartilage matrix organization as a result of modification of collagen mesh and consequent changes of epiphysis of the lower limbs form. There is no possibility of prevention and etiological therapy of coxarthritis evolving from epiphyseal dysplasia, meanwhile there is a threat of decompensation of reparatory bone tissue potential in epiphysis zone in this patient category. Therefore, in patients with coxarthritis and radiographic signs of epiphyseal dysplasia, resistant to the course of conservative treatment, it is advisable do not delay use the method of joint arthroplasty.

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Section: Introductionmentioning

confidence: 99%

Histological features of articular cartilage and bone marrow reparative potential under conditions of coxarthritis in patients with radiographic signs of epiphyseal dysplasia

Huzhevskyi,

Herasymenko,

Poluliakh

et al. 2023

OTP

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“…Multiple epiphyseal dysplasia (MED) is a rare, congenital bone dysplasia characterized by abnormal ossification of multiple epiphyses [ 1 ]. It affects 10 per 100,000 individuals worldwide [ 2 ]. The clinical presentations include short stature, angular or rotational deformity of the extremities, intermittent joint pain, and/or precocious osteoarthritis.…”

Section: Introductionmentioning

confidence: 99%

The favorable outcome of Bernese periacetabular osteotomy for the hip osteoarthritis in multiple epiphyseal dysplasia

Chang,

Lee,

Lin

et al. 2023

Orphanet J Rare Dis

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Background Multiple epiphyseal dysplasia (MED) is a rare congenital bone dysplasia. Patients with MED develop secondary hip osteoarthritis as early as the third to the fourth decade. Currently, there is no consensus on the prevention of the progressive hip osteoarthritis secondary to MED. The Bernese periacetabular osteotomy (PAO) is a joint-preserving surgery to reshape acetabulum and extend femoral head coverage. However, there is no documentary evidence for the effect of the procedure on MED hips. Patients and methods We analyzed the preliminary outcomes following the Bernese PAO in 6 MED hips. The average age at the time of surgery was 14.3 years (range from 11.4 to 17.2 years). For our study interest of time efficiency, radiographic parameters were analyzed preoperatively and 1 year postoperatively. The hip function was evaluated by the Harris Hip Score (HHS) before and after surgery. Results The mean follow-up time was 1.7 years. The mean lateral center–edge angle increased from 3.8° to 47.1° (p = 0.02), anterior center–edge angle increased from 7.3° to 35.1° (p = 0.02), and acetabulum index decreased from 27.8° to 14.6° (p = 0.04). The femoral head coverage ratio increased from 66.8% to 100% (p = 0.02). The post-operative anteroposterior pelvic radiograph demonstrated all preoperative broken Shenton lines were reversed. The mean HHS improved from 67.3 to 86.7 (p = 0.05). Conclusion Bernese PAO is a feasible treatment for hip disorders in MED patients. It reshapes acetabular and femoral morphology efficiently. In our study, the preliminary results showed the procedure not only improved radiographic outcomes but also hip function.

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“…El tratamiento se fundamenta en el diagnóstico precoz y el seguimiento del paciente; se recomienda reposo y descarga con bastones en la coxalgia durante la infancia, así como el uso de analgésicos en pacientes con artralgias (Borrego et al, 2014). La artritis degenerativa, que produce intenso dolor y discapacidad, requiere frecuentemente artroplastia total de cadera antes de los 30 años (Vanlommel et al, 2018).…”

Section: Introductionunclassified

Displasia epifisiaria múltiple: un hallazgo radiológico casual como clave diagnóstica

Silva

Martorelli

Rocha

et al. 2022

GICOS

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La Displasia Epifisaria Múltiple es una alteración genética que afecta el crecimiento y remodelación del hueso; está caracterizada por una anomalía en el desarrollo de las epífisis y deformidades óseas que afectan a las articulaciones y provocan artrosis tempranas en los niños. Las manifestaciones suelen aparecer entre los dos y 10 años de edad; se pueden detectar en pacientes de estatura baja, con deformidades epifisarias que dan lugar a disfunción articular en forma de dolor, rigidez y/o limitación al movimiento, particularmente en edad adulta, pudiendo pasar desapercibida durante la infancia. El tratamiento es sintomático y los aspectos claves son diagnóstico precoz, reposo, analgesia, seguimiento y prótesis de cadera en los casos de artrosis. El objetivo de este trabajo es presentar un caso clínico cuyo diagnóstico fue realizado a partir de un hallazgo radiológico casual posterior a un traumatismo Se trata de preescolar masculino de cinco años, a quien se le determina diagnóstico posterior a traumatismo en miembro inferior izquierdo, en vista de hallazgos radiológicos anormales como hallazgo casual. Se resalta la importancia de la historia clínica en displasias esqueléticas con manifestaciones mínimas para lograr el diagnóstico correcto, tratamiento oportuno y detección precoz de posibles complicaciones, con el fin de mejorar el pronóstico a largo plazo del afectado.

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Hybrid total hip arthroplasty for multiple epiphyseal dysplasia

Abstract: Level IV, retrospective study.

Cited by 9 publications

References 29 publications

Histological features of articular cartilage and bone marrow reparative potential under conditions of coxarthritis in patients with radiographic signs of epiphyseal dysplasia

Histological features of articular cartilage and bone marrow reparative potential under conditions of coxarthritis in patients with radiographic signs of epiphyseal dysplasia

The favorable outcome of Bernese periacetabular osteotomy for the hip osteoarthritis in multiple epiphyseal dysplasia

Displasia epifisiaria múltiple: un hallazgo radiológico casual como clave diagnóstica

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