Osteogenesis Imperfecta—Who Needs Rodding Surgery?

Fassier, François

doi:10.1007/s11914-021-00665-z

Cited by 16 publications

(13 citation statements)

References 30 publications

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“…In a review of the literature, the main reasons for revision surgery were migration of the male/female component, refracture/nail bending, and delayed union [ 7 , 18 , 19 ]. In our series, migration of the female component and nail bending were common reasons for failure in the femur, while migration of the male component and delayed union were common reasons for failure in the tibia, which is described in Table 2 .…”

Section: Discussionmentioning

confidence: 99%

“…Migration of the male component is common in the tibia due to an almost empty epiphysis [ 18 , 19 ]. For the male component, short thread screws are designed to anchor the epiphysis and resist a pulling out force due to growth [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

“…Since the distal epiphysis of the femur is larger than the distal epiphysis of the tibia, there is a relatively lower risk of distal dislodgement in the femur (tibia 4, femur 1 in our series) due to sufficient distal purchase. Migration of the male component is common in the tibia due to an almost empty epiphysis [18,19]. For the male component, short thread screws are designed to anchor the epiphysis and resist a pulling out force due to growth [15].…”

Section: Principle 1: Enough Depth Of Nail Purchase In Distal and Pro...mentioning

confidence: 99%

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Surgical Strategy to Decrease the Revision Rate of Fassier–Duval Nailing in the Lower Limbs of Osteogenesis Imperfecta

Hung

Cheng

Lin

et al. 2022

JPM

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(1) Background: The Fassier–Duval (FD) nail was developed for the treatment of osteogenesis imperfecta (OI). The aim of this study was to review the results of OI patients treated with the FD nail at our institution and discuss a surgical strategy to decrease the FD nail revision rate; (2) Methods: We retrospectively reviewed OI patients treated at our institution between 2015 and 2020. OI patients treated with FD nail insertion in the long bones of the lower extremities were included, and those with a follow-up duration <1 year or incomplete radiographs were excluded. Data on the type of OI, age, sex, use of bisphosphonate treatment, and nail failure were recorded; (3) Results: The final cohort consisted of seven patients (three females and four males) with ten femurs and ten tibiae involved. Six of the patients had type III OI, and one had type IV OI. An exchange of implant was required in 11 limbs. The average interval between previous FD nail insertion and revision surgery was 2.4 years; (4) Discussion: The main reasons for revision surgery were migration of the male/female component, refracture/nail bending, and delayed union. In the femur, migration of the female component or nail bending were common reasons for failure, while migration of the male component and delayed union were common in the tibia; (5) Conclusions: Surgery for OI patients is challenging, and physicians should aim to minimize complications and the need for revision. Sufficient depth of purchase, center–center nail position, and adequate osteotomy to correct bowing are the key factors when using the FD nail.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Principle 1: Enough Depth Of Nail Purchase In Distal and Pro...mentioning

confidence: 99%

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Surgical Strategy to Decrease the Revision Rate of Fassier–Duval Nailing in the Lower Limbs of Osteogenesis Imperfecta

Hung

Cheng

Lin

et al. 2022

JPM

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“… 5 Depending on the location of the mutations, abnormal molecular characteristics of collagen type I increase the risk of periarticular and diaphyseal fractures that alter joint biomechanics. 6 Periarticular bone dysplasia with subchondral insufficiency may accelerate the development of osteoarthritis. 1 Conservative therapy of osteoarthritis is usually recommended in adults with osteogenesis imperfecta.…”

Section: Introductionmentioning

confidence: 99%

Challenges of total knee arthroplasty in osteogenesis imperfecta: case report and literature review

2022

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The majority of adults with mild osteogenesis imperfecta report significant functional impairment due to musculoskeletal concerns. Knee osteoarthritis is common in these patients. Although total knee arthroplasty has become a highly efficient surgical technique for osteoarthritis, this procedure remains uncommon in patients with osteogenesis imperfecta. This current case report describes the important clinical aspects of osteogenesis imperfecta that must be considered during the planning and performance of a total knee replacement. A 62-year-old female patient with a history of osteogenesis imperfecta suffered from severe osteoarthritis of the knee with valgus deformity. Two years after posterior stabilized total knee arthroplasty, her Hospital for Special Surgery knee score had improved from preoperative 53 points to 85 points at the final follow-up. The current case report describes the crucial technical aspects of a successful total knee replacement in this uncommon scenario. Underlying deformities and concomitant pathologies constitute specific surgical challenges. Special care should be taken to protect the patient from potential complications.

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“…Treatment for OI is a great challenge, which is primarily supportive and symptomatic, including management with medications, physical therapy, and even orthopedic interventions to improve bone strength, reduce fracture risk, and improve mobility (5,6). Bisphosphonates (BPs) are the most commonly used medications for OI, which can increase bone mineral density (BMD), reduce bone fracture risk, and lead to the reshaping of the vertebra (7)(8)(9)(10), but the optimal duration of BP therapy in OI patients is unknown.…”

Section: Introductionmentioning

confidence: 99%

Skeletal outcomes of patients with osteogenesis imperfecta during drug holiday of bisphosphonates: a real-world study

Zhang

Lin

et al. 2022

Front. Endocrinol.

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PurposeThis study aimed to investigate the skeletal outcomes of patients with osteogenesis imperfecta (OI) who received bisphosphonate (BP) treatment and entered drug holiday after achieving an age- and sex-specific bone mineral density (BMD) reference.MethodsPatients with OI receiving BP treatment were enrolled when they entered drug holidays of BPs. The skeletal outcomes were evaluated in detail during the drug holiday, including BMD, X-ray of the bone, bone fracture incidence, and bone turnover biomarkers. The pathogenic mutations of OI were identified by next-generation sequencing and confirmed by Sanger sequencing.ResultsA total of 149 OI patients (127 juveniles and 22 adults) who entered drug holidays after nearly 4 years of BP treatment were included. Areal BMD at the lumbar spine increased from 0.934 ± 0.151 to 0.990 ± 0.142 g/cm2 and was stable in the second (1.029 ± 0.176 g/cm2) and third years (1.023 ± 0.174 g/cm2) of BP drug holidays, and BMD at the femoral neck, trochanter, and total hip had no significant change, but it was gradually inferior to that of the same-gender juveniles in the second and third years of the drug holiday. BMD at the lumbar spine and proximal hip did not change and was inferior to that of the same-gender adults. The average time of fractures fluctuated from 0.18 to 0.08 per year in juveniles, while only one adult suffered from a fracture during BP drug holidays. Bone turnover markers were in the normal range, except for a mildly high level of β-carboxy-terminal cross-linked telopeptide of type 1 collagen in the juvenile group. A total of 17 (11.4%) patients received BP retreatment because of bone loss during the drug holiday. OI type III and type IV and COL1A2 mutation were correlated to a longer duration of BP treatment to enter drug holidays (all p < 0.05). Old age at initial treatment (OR, 1.056) and OI type III (OR, 10.880) were correlated to a higher risk of BP retreatment.ConclusionsOI patients will undergo nearly 4 years of BP treatment to achieve drug holidays. During the 3 years of the drug holiday, the patients’ BMD is stable, and fracture incidence does not increase significantly. Patients are more inclined to need retreatment during drug holidays owing to the late start of BP treatment and more severe OI phenotypes.

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Osteogenesis Imperfecta—Who Needs Rodding Surgery?

Cited by 16 publications

References 30 publications

Surgical Strategy to Decrease the Revision Rate of Fassier–Duval Nailing in the Lower Limbs of Osteogenesis Imperfecta

Surgical Strategy to Decrease the Revision Rate of Fassier–Duval Nailing in the Lower Limbs of Osteogenesis Imperfecta

Challenges of total knee arthroplasty in osteogenesis imperfecta: case report and literature review

Skeletal outcomes of patients with osteogenesis imperfecta during drug holiday of bisphosphonates: a real-world study

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