Total joint arthroplasty in a patient with osteopetrosis: 10-year follow-up

Total joint arthroplasty may be considered as a last option to treat osteopetrosis associated with osteoarthritis. However, many intraoperative and postoperative challenges need to be overcome when performing arthroplasty in patients with osteopetrosis, and few studies have focused on the longer-term outcomes.This article describes a case of a 22-year-old woman with osteopetrosis who presented with osteoarthritis and underwent right total hip arthroplasty 10 years prior. A smaller and shorter femoral component was chosen for the patient, special tungsten steel drill bits were used to create the femoral canal, and the drilling process was under fluoroscopic guidance. In the second postoperative week, her Harris Hip Score increased to 82.15 points from 40.25 points preoperatively. No postoperative complications were seen, and radiographs illustrated the components were in good position. At 10-year follow-up, her Harris Hip Score was still 82 points, the components were in good position radiographically, and the patient could walk freely and perform activities of daily living with no pain. The success of the treatment lies in suitable selection of prosthesis components, extra caution during surgery, adequate perioperative antibiotic administration, postoperative functional exercise, and a low-calcium diet.