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成骨不全症患者的全膝关节置换术:病例报告

Total knee arthroplasty in osteogenesis imperfecta: case report.

作者信息

Nishimura Akinobu, Hasegawa Masahiro, Kato Ko, Fukuda Aki, Sudo Akihiro, Uchida Atsumasa

机构信息

Department of Orthopaedic Surgery, Graduate School of Medicine, Mie University, Tsu City, Mie, Japan.

出版信息

Knee. 2008 Dec;15(6):494-6. doi: 10.1016/j.knee.2008.07.005. Epub 2008 Aug 30.

Abstract

Osteogenesis imperfecta (OI) is a rare congenital disorder of type capital I, Ukrainian collagen production that results in brittle bones and affects body systems containing collagen. The increasing life span of patients with OI has recently revealed a high incidence of osteoarthritis of the knee. A 53 year-old man with OI presented with bilateral knee pain. He had severe deformities of the proximal part of the femur with subsegment post-traumatic osteoarthritis of both sides of the knees. However, the frequency of fracture gradually decreased and he had not experienced a fracture for 17 years. His bone mineral density was extremely low for his age. He underwent cemented total knee arthroplasty (TKA) on the left knee. One year later, the patient had relief of pain and he could walk without assistance. To our knowledge, only three knee replacements in two patients with OI have been reported, so this case is extremely rare. Although whether a patient with OI is a suitable candidate for knee replacement, it was a useful treatment for osteoarthritis in this case.

摘要

成骨不全症(OI)是一种罕见的I型先天性疾病,由于胶原蛋白生成异常,导致骨骼脆弱,并影响含有胶原蛋白的身体系统。近年来,OI患者寿命的延长显示出膝关节骨关节炎的高发病率。一名53岁的OI男性患者出现双侧膝关节疼痛。他的股骨近端严重畸形,双侧膝关节创伤后亚段骨关节炎。然而,骨折频率逐渐降低,他已有17年未发生骨折。按其年龄,他的骨矿物质密度极低。他接受了左膝骨水泥全膝关节置换术(TKA)。一年后,患者疼痛缓解,能够独立行走。据我们所知,仅报道过两例OI患者的三次膝关节置换手术,因此该病例极为罕见。尽管OI患者是否适合进行膝关节置换尚不确定,但在该病例中,这是治疗骨关节炎的有效方法。

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