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Review
. 2024 Oct 15;32(20):938-945.
doi: 10.5435/JAAOS-D-23-01208. Epub 2024 Aug 13.

Challenges of Hip and Knee Arthroplasty in Patients With Osteopetrosis

Gautier Beckers  1 , David Mazy, Pascal-André Vendittoli, Mina W Morcos, Vincent Massé
Affiliations
Review

Challenges of Hip and Knee Arthroplasty in Patients With Osteopetrosis

Gautier Beckers et al. J Am Acad Orthop Surg. .

Abstract

Osteopetrosis is a rare metabolic bone disease, characterized by dysfunction of osteoclasts, resulting in increased bone density and brittleness leading to pathological fractures and bone deformities. Hip and knee osteoarthritis (OA) are common long-term complications in patients with osteopetrosis. Joint arthroplasty surgery remains an effective and recommended treatment for these patients with an end-stage OA because it provides favorable outcomes. However, in osteopetrosis, joint arthroplasty surgery carries an increased risk of complications, and specific preoperative and perioperative considerations are required to deal with the technical challenges related to the disease. The aim of this article was to review some of the key aspects of osteopetrosis, provide technical recommendations, and answer clinically relevant questions related to hip and knee arthroplasty surgery.

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Conflict of interest statement

None of the following authors or any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Beckers, Dr. Mazy, Dr. Vendittoli, Dr. Morcos, and Dr. Massé

Figures

Figure 1
Figure 1
Anteroposterior and lateral knee radiographs demonstrating a patient with osteopetrosis. Increased bone density and complete filling of the medullary cavity can be seen.
Figure 2
Figure 2
Radiographs demonstrating typical “bone within a bone" appearance in a 75-year-old patient with osteopetrosis.
Figure 3
Figure 3
AP radiographs demonstrating a 71-year-old woman with osteopetrosis and left groin pain. A, Left hip OA and remote proximal femur osteosynthesis. B, Status after left cemented total hip arthroplasty (THA). C, 4 years later, after right THA. (D) Periprosthetic Vancouver C femur fracture 8 months after right THA surgery treated by open reduction and plate fixation.
Figure 4
Figure 4
Preoperative radiograph (left) demonstrating a 16-year-old patient with osteopetrosis treated with a left hip resurfacing at 16 years of age. Last follow-up radiograph (right) of the same patient, 7 years after surgery. She is very active and pain free.
Figure 5
Figure 5
Example of an ideal case of resurfacing surgery. Anteroposterior pelvic radiograph showing a coxa valga deformity in a young patient with osteopetrosis.
See this image and copyright information in PMC

References

    1. Shapiro F: Osteopetrosis. Current clinical considerations. Clin Orthop Relat Res 1993;294:34-44. - PubMed
    1. Stark Z, Savarirayan R: Osteopetrosis. Orphanet J Rare Dis 2009;4:5. - PMC - PubMed
    1. Sloan M, Premkumar A, Sheth NP: Projected volume of primary total joint arthroplasty in the U.S., 2014 to 2030. J Bone Joint Surg Am Vol 2018;100:1455-1460. - PubMed
    1. Krzysztof H, Wlodarski MD: Properties and origin of osteoblasts. Clin Orthop 1990;252:276-289. - PubMed
    1. Boyce BF, Xing L: Biology of RANK, RANKL, and osteoprotegerin. Arthritis Res Ther 2007;9suppl 1:S1. - PMC - PubMed

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