Can Chiari Osteotomy Favorably Influence Long-term Hip Degradation in Multiple Epiphyseal Dysplasia and Pseudoachondroplasia?

Andrzejewski, Aurélie; Péjin, Zagorka; Finidori, G; Badina, Alina; Glorion, Christophe; Wicart, Philippe

doi:10.1097/bpo.0000000000001708

Cited by 6 publications

(10 citation statements)

References 29 publications

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“…Andrzejewski et al . [20] evaluated the efficacy of Chiari osteotomy in MED and PSACH patients. This study had an average of 20-year follow-up on 20 patients (14 MED) and found the PMA score improved from 12.7 preoperatively to 15.2 postoperatively.…”

Section: Discussionmentioning

confidence: 99%

Treatment outcomes of hips in patients with epiphyseal dysplasia

Lindgren

Bomar

Upasani

et al. 2022

Journal of Pediatric Orthopaedics B

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Hip containment surgeries in multiple epiphyseal and spondyloepiphyseal dysplasia (MED/SED) patients aim to improve the mechanical environment of the hip joint. The purpose of this study was to determine if surgical intervention to improve femoral head coverage improved radiographic and clinical outcomes. A retrospective study identified patients with MED/SED seen in clinic between May 2000 and September 2017, with a minimum of 2-year follow-up. Patient charts/radiographs were reviewed for radiographic hip measurements, pain, and gait. Sixty-nine hips in 35 patients were identified. Forty-four hips were treated nonoperatively and 25 were treated surgically. The mean age at diagnosis was 6.2 years. The mean follow-up was 7.7 years for the surgical group and 7.1 years for the nonsurgical group. The mean postoperative follow-up was 5.4 years. Acetabular index decreased from initial to final visit by 9.0° in the surgical group and 1.6° in the nonsurgical group. Tonnis angle decreased by 13.5° in the surgical group and 1.5° in the nonsurgical group. Center edge angle increased by 19.0° in the surgical group and 7.1° in the nonsurgical group. Hips in the surgical group were 6.1 times more likely to experience an improvement in pain compared with hips in the nonsurgical group. Gait at the final follow-up was similar among the two groups. In this study cohort, containment surgery provided increased femoral head coverage; however, there was equal femoral head deformation despite intervention. Hips treated surgically were more likely to experience an improvement in pain; however, gait alterations did not improve.

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Section: Discussionmentioning

confidence: 99%

Treatment outcomes of hips in patients with epiphyseal dysplasia

Lindgren

Bomar

Upasani

et al. 2022

Journal of Pediatric Orthopaedics B

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“…To delay the onset of premature osteoarthritis, various osteotomies have been indicated for correcting deformities. 5 , 6 ) Growth modulation procedures through hemiepiphysiodesis were also employed at the growth plates of the distal femur and proximal tibia in patients before skeletal maturity. 21 ) However, the long-term results of these realignment procedures remain unproven.…”

Section: Discussionmentioning

confidence: 99%

“… 4 ) To prevent early osteoarthritis, some patients undergo osteotomy to realign the lower extremities. 5 , 6 ) In addition to early osteoarthritis, MED is characterized by a disproportionate short stature. 7 ) As well as premature osteoarthritis, orthopedic problems in SED include disproportionate short stature, scoliosis, odontoid hypoplasia, and atlantoaxial instability.…”

Section: Introductionmentioning

confidence: 99%

Health-related Quality of Life in Adult Patients with Multiple Epiphyseal Dysplasia and Spondyloepiphyseal Dysplasia

Matsushita

Mishima

Kamiya

et al. 2021

PRM

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Objectives: Multiple epiphyseal dysplasia (MED) and spondyloepiphyseal dysplasia (SED) are skeletal dysplasias associated with premature osteoarthritis and short stature. Patients with SED often have spinal and ocular problems. Few reports have focused on the health-related quality of life (HRQoL) of patients with skeletal dysplasias associated with premature osteoarthritis. The purpose of this study was to evaluate the HRQoL of adult patients with MED and SED. Methods: Questionnaires covering demographics, medical history (cataract, retinal detachment, and osteoarthritis), surgical history (osteotomy and arthroplasty), and the Short Form-36 (SF-36) health survey were sent to all patients with MED and SED with medical records at the investigators’ institutions. Among the 27 patients who completed the questionnaire, patients aged 20 years or older were included in this cohort. Results: The subjects were 18 affected individuals. The physical component summary score (PCS) was significantly lower in the MED and SED groups than in the normal population and tended to deteriorate with age. Conversely, there was a positive correlation between the mental component summary score and age. The role/social component summary score was not correlated with age. MED patients with osteoarthritis had a low PCS. PCS was particularly low in two SED patients with a medical history of cataract, whereas there was no association with a history of retinal detachment or osteoarthritis. Conclusions: The physical domain of HRQoL in MED and SED patients significantly deteriorated at a young age. Appropriate medical management of these skeletal dysplasias is required not only for orthopedic functions but also for ocular problems.

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“…Femoral and pelvic osteotomies are also performed in patients who have sequelae of developmental dysplasia of the hip, sequelae of septic arthritis of the hip, Legg-Calvé-Perthes disease, in skeletal dysplasia etc. (5,6,7).…”

Section: Introductionmentioning

confidence: 99%

Intraoperative Goal-Directed Therapies in Femoral and Pelvic Osteotomies in Children and In-Hospital Postoperative Outcomes

Kumba

Gaumé

Barbarian

et al. 2021

Preprint

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Background: Femoral and pelvic osteotomies are potential hemorrhagic interventions where transfusion requirements can be necessary.Objective: We undertook a secondary analysis of patients who underwent femoral and pelvic osteotomy in the initial cohort. The objective of this secondary analysis was to describe intraoperative and postoperative outcomes and to describe intraoperative management in these patients in terms of blood product management, fluid and hemodynamic therapy with the aim of implementing optimization management protocols for postoperative outcome improvement.Methods: A secondary analysis of patients who underwent femoral and pelvic osteotomy surgery was included in the initial retrospective study.Results: There were eighteen patients with a mean age of 104± 47.1 months. Four (22.2%) patients had intraoperative and/or postoperative complications. One patient (5.6%) had intraoperative hemorrhagic shock, two patients (11.1%) had postoperative neurologic failure, and one patient (5.6%) had postoperative wound sepsis. Transfusion rate was 50% in nine patients.Conclusion: Femoral and pelvic osteotomies are interventions where blood, transfusion and fluid requirements can be increased; thus, this implies the necessity of a global patient blood management protocol with point-of-care tests and fluid- and hemodynamic-guided protocols with validated tools in children for intraoperative and postoperative outcome optimization.

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Can Chiari Osteotomy Favorably Influence Long-term Hip Degradation in Multiple Epiphyseal Dysplasia and Pseudoachondroplasia?

Cited by 6 publications

References 29 publications

Treatment outcomes of hips in patients with epiphyseal dysplasia

Treatment outcomes of hips in patients with epiphyseal dysplasia

Health-related Quality of Life in Adult Patients with Multiple Epiphyseal Dysplasia and Spondyloepiphyseal Dysplasia

Intraoperative Goal-Directed Therapies in Femoral and Pelvic Osteotomies in Children and In-Hospital Postoperative Outcomes

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