Total knee replacement in Osteogenesis Imperfecta: a case report and review of the literature

Abstract

Background A review of the literature revealed that only 9 total knee replacements were performed on patients with osteogenesis imperfecta (OI), with one being a revision procedure of a periprosthetic fracture. Of the 9 primary procedures, all used cemented prostheses, and 3 patients had an osteotomy at the same procedure. Our patient required a hinged prosthesis because of collateral ligament incompetence and is the first such case reported in the literature. Case presentation Presented here is a total knee replacement performed on a 52-year-old patient with osteogenesis imperfecta (OI) who injured her left knee and ruptured her anterior cruciate ligament. Her right knee suffered from severe degenerative changes with an incompetent medial collateral ligament. It was decided to replace the right knee before addressing the left knee injury. A hinged revision prosthesis was used. The smallest components available were used because of the small anatomical bony dimensions. Conclusion This is the first reported case of a hinged prosthesis and highlights the soft tissue component of osteogenesis imperfecta. We also highlight the technical problems with these patients, including mal-alignment, small bony dimensions and bone fragility.

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

“…To the best of our knowledge, only 12 total knee replacements in 10 patients with osteogenesis imperfecta and knee osteoarthritis have been reported in the existing literature. 8 , 9 , 14 – 18 The characteristics of the previously published cases are presented in Table 1 . 8 , 9 , 14 – 18 One additional case report described a failed hip femoral revision component perforating the femoral trochlea due to poor bone quality that was treated by total femur replacement.…”

“… 8 , 9 , 14 – 18 The characteristics of the previously published cases are presented in Table 1 . 8 , 9 , 14 – 18 One additional case report described a failed hip femoral revision component perforating the femoral trochlea due to poor bone quality that was treated by total femur replacement. 19 …”

“…Summary of previously reported cases of total knee arthroplasty (TKA) used for osteoarthritis in patients with osteogenesis imperfecta 8,9,[14][15][16][17][18]. …”

Endoprothetische Versorgung von Patienten mit Skelettdysplasien

“…Die wenige verfügbare Literatur im Hinblick auf endoprothetische Versorgungen bei Patienten mit OI liest sich insofern auch kritisch und zeigt teils hohe Revisionsraten und vergleichsweise kurz Standzeiten der Implantate [14,16,17,21,22]. In der Erfahrung des Verfassers lassen sich aber bei sorgfältiger präoperativer Vorbereitung unter Einbeziehung der o.g.…”

Correction to: Total knee replacement in Osteogenesis Imperfecta: a case report and review of the literature

“…Following publication of the original article [ 1 ], the authors reported an error for some numbers in the sentence “her visual analogue score (VAS) was 3/10, 7/10 and 8/10 before, 6 and 24 months after surgery respectively” in the Case report section.…”