Total hip replacement in adult patients with severe Kashin-Beck disease of the hip

Tang, Xin; Zhu, Jing; Zhou, Zongke; Shen, Bin; Kang, Pengde; Pei, Fuxing; Li, Jian

doi:10.1186/s12891-016-1119-3

Cited by 9 publications

(8 citation statements)

References 32 publications

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“…At present, the diagnosis and determination of KBD grades are primarily dependent on symptoms and changes observed by X-ray, but it is only effective for diagnosing the advanced cases of KBD with grades II and III. Thus, it is extremely difficult to correctly diagnose the early stages of KBD with grades I and II, leading to inevitable exacerbation of symptoms [5, 14]. In this study, we found that brachydactylia, deformity of the knee, and dyskinesia in joints of the elbow and knee were significantly different between KBD patients with grades I and II, which could provide the new indicators for diagnosis of KBD patients with grades I and II.…”

Section: Resultsmentioning

confidence: 68%

Biological Analysis of Gene Expression and Clinical Variables Suggest FZD1 as a Novel Biomarker for Patients with Kashin-Beck Disease, an Endemic Osteoarthritis in China

et al. 2019

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Clinical variables contribute to the severity of Kashin-Beck disease (KBD). However, it is unclear if there is a correlation between gene expression and clinical variables. Peripheral blood samples were collected from 100 patients with KBD and 100 healthy controls from KBD-endemic areas to identify differentially expressed genes in KBD. Correlation analysis and multiple logistic regression analysis were performed using gene expression and clinical parameters. Immunohistochemistry (IHC) was used to detect the expression of related proteins in articular cartilage tissues. Thirty-nine differentially expressed genes were identified in patients with KBD. Nine differentially expressed genes were correlated with the metacarpal length/metacarpal breadth index. FZD1 was identified as having statistical significance in establishing the regression model of clinical parameters and gene expression. FZD1 expression levels were remarkably reduced in patients with KBD. Our results indicate that FZD1 could be involved in the pathological process of phalanges tuberositas and brachydactylia and may provide new insight into the pathogenesis of articular cartilage destruction observed in patients with KBD.

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Section: Resultsmentioning

confidence: 68%

Biological Analysis of Gene Expression and Clinical Variables Suggest FZD1 as a Novel Biomarker for Patients with Kashin-Beck Disease, an Endemic Osteoarthritis in China

et al. 2019

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“…There is no specific treatment for KBD, and when it invades joints throughout the body, the treatment protocol for osteoarthritis (OA) can be referred to. Previous literature ( 6 ) found that THA was effective in relieving pain and improving joint function after total hip arthroplasty in 22 (32 hips) elderly patients with advanced KBD. Treatment was also staged according to different symptoms and age ( 10 ).…”

Section: Discussionmentioning

confidence: 95%

“…KBD mainly destroys cartilage cells at the epiphysis and joints symmetrically in children, thus affecting growth and even risking deformity and disability ( 5 ). Arthroplasty is the most effective treatment for patients with advanced KBD who have failed conservative treatment and have severe joint lesions ( 6 ). It was previously believed that patients with cumulative bilateral joint lesions due to various etiologies had more complications with one-stage surgery ( 7 ).Therefore, the more symptomatic side is chosen for staged surgery.…”

Section: Introductionmentioning

confidence: 99%

Case report: A 3-year follow-up study of simultaneous bilateral total hip arthroplasty for Femoral head necrosis in a patient with Kashin-Beck Disease

Chen

Liu²,

Wang

et al. 2022

Front. Surg.

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IntroductionKashin-Beck Disease (KBD) is an endemic disease predominantly affecting joint and skeletal muscle, predisposing the articular cartilage to degeneration and necrosis. Currently,staged total hip arthroplasty is a common surgical method for advanced femoral head necrosis from KBD, but there are no reports in the literature on simultaneous bilateral total hip arthroplasty (SB-THA) for patients with KBD.Case presentationA 42-year-old male from Shaanxi Province, an endemic area, had bilateral hip pain for 4 years, with hips inversion and a crossed gait. After preoperative preparation, a SB-THA was performed by a posterolateral approach. Postoperative medication and functional exercises were administered and the patient was followed up for at least 3 years after discharge. The patient's hip mobility, hip scores and quality of life scores were recorded in detail during the follow-up.ResultThe patient stopped antibiotic treatment on the postoperative day-2, and all inflammatory indicators showed normal and started appropriate exercise, and the pain score decreased significantly. On the postoperative day-7, the patient had gradually adapted to various forms of rehabilitation exercises. He was discharged from the hospital on the postoperative day-10 and continued to be followed up. From the preoperative period to the last follow-up, the patient's bilateral hip mobility and functional scores improved significantly, and no adverse events such as hip pain, prosthesis loosening or dislocation were found at the last follow-up.ConclusionThe patient's performance was satisfactory both intraoperatively and in the early postoperative period, but the hip scores and quality of life scores began to plateau or even decline from the third year after surgery to the last follow-up, probably due to the influence of further damage to articular cartilage in other parts of the body.

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“…In addition, the proportions of physical therapy and surgical procedures were both signi cantly low, although previous studies reported that the two methods were effective. [17][18][19]. One explanation for this nding may be that the KBD patients may not have the stamina to engage in physical therapy due to long-term treatment; the other is that the subjects may not be able to afford the cost of surgery due to nancial reasons [40].…”

Section: Discussionmentioning

confidence: 99%

“…Currently, relieving the pain is an important target in the treatment of KBD [14]. However, pain treatment for KBD is mainly derived from experiences of osteoarthritis (OA) [15], including the administration of analgesic drugs [5], selenium supplementation [16], intra-articular injections of hyaluronic acid (IAHA) [14], surgical procedures [17,18] and physical therapy [19]. Despite various treatment approaches, there is no speci c disease pain measurement to assess joint pain after treatment.…”

mentioning

confidence: 99%

Does Kashin-beck Disease Present Only Multisite Pain? A Cross-sectional Study of Pain Characteristics in Northwest China

Wang

Younus²,

Xu³

et al. 2020

Preprint

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BackgroundKashin-Beck Disease (KBD) is an endemic, chronic joint disease. Multisite joint pain is the primary symptom of KBD, which have profound negative effects on individuals and society. However, studies on joint pain characteristics among the KBD population are still limited. The aims of this study were to explore characteristics of joint pain in patients with KBD and determine associated factors with joint pain. MethodsThis cross-sectional study included 167 patients with KBD and 169 patients from the general population with joint pain from Shaanxi Province in northwest China. Subjects were asked about joint pain characteristics and completed the numeric rating scale (NRS), the graded chronic pain scale (GCPS) and the EuroQol (EQ-5D) questionnaire. Differences between groups were determined using Chi-square, Student’s t, Mann–Whitney U and 1-way ANOVA tests.ResultsCompared with the general group, patients with KBD reported a higher number of pain sites (7.2±3.8 vs 3.5± 1.8), a higher frequency of persistent pain (98.8% vs 50.9%), a higher percentage of analgesics usage (89.2% vs 30.7%), a higher pain intensity (73.8±15.2 vs 50.0±20.7) and pain –related disability (61.2±23.3 vs 41.6±23.2), and lower EQ-5D scores (0.34±0.27 vs 0.59±0.16). Among the 167 KBD patients, painful joints were symmetrically distributed between the bilateral limbs; the 5 most frequently reported painful joints for the bilateral sides were the knees (84.8%), ankles (79.2%), wrists (51.2%), shoulders (49.5%) and elbows (47.7%). The most severe pain joint was the knee (NRS:6.6), followed by the ankles (NRS:5.1), the fingers, shoulders and elbows had the similar NRS scores (NRS:4.0). Additionally, KBD patients experienced neuropathic pain to varying degrees. Compared to males, females reported a higher number of total pain sites, higher intensity and lower quality of life. ConclusionsBesides multisite pain, the KBD patients suffered from symmetrical, persistent, and neuropathic pain. Weight-bearing joints (e.g., knee and ankle) were the most painful. These findings will provide scientific basis for establishing joint pain evaluation criteria and future pain intervention strategies for these KBD patients in China.

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Total hip replacement in adult patients with severe Kashin-Beck disease of the hip

Cited by 9 publications

References 32 publications

Biological Analysis of Gene Expression and Clinical Variables Suggest FZD1 as a Novel Biomarker for Patients with Kashin-Beck Disease, an Endemic Osteoarthritis in China

Biological Analysis of Gene Expression and Clinical Variables Suggest FZD1 as a Novel Biomarker for Patients with Kashin-Beck Disease, an Endemic Osteoarthritis in China

Case report: A 3-year follow-up study of simultaneous bilateral total hip arthroplasty for Femoral head necrosis in a patient with Kashin-Beck Disease

Does Kashin-beck Disease Present Only Multisite Pain? A Cross-sectional Study of Pain Characteristics in Northwest China

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