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[Diagnosis and therapy of Paget's osteodystrophy deformans of the hip]
H Zollinger1, R Gampp, M A Dambacher
1Orthopädische Universitätsklinik Balgrist, Zürich.
Insights
Half of Paget
Area of Science:
- Orthopedics
- Rheumatology
- Bone Metabolism
Background:
- Paget's disease of the hip affects bone structure and can cause pain.
- Symptomatic cases often involve secondary complications like deformities and fractures.
Purpose of the Study:
- To analyze the clinical presentation and surgical outcomes in patients with Paget's disease of the hip.
- To evaluate the impact of altered bone consistency on surgical procedures and prosthesis longevity.
Main Methods:
- Retrospective analysis of 78 patients diagnosed with Paget's disease of the hip.
- Review of patient records focusing on symptoms, surgical interventions, and complications.
Main Results:
- 50% of patients were asymptomatic; the other 50% experienced pain.
- Secondary hip joint arthroses, deformities, and fractures were common causes of pain.
- Surgical intervention was required in 15 cases, with challenges related to bone consistency and prosthesis loosening observed.
Conclusions:
- Paget's disease of the hip presents with varied symptomatic profiles.
- Altered bone quality poses surgical challenges, particularly concerning joint replacement.
- Fracture healing and osteotomy consolidation are generally unaffected, and osteotomy corrections demonstrate durability.
Abstract:
Of 78 patients with Paget's Disease of the hip at the Balgrist clinic, one-half are free of pain; the other one-half have symptoms. The complaints are caused primarily by secondary bone and joint pain in cases with deformities and fractures of the proximal femur, or arthroses or protrusion of the hip joint, which necessitated surgical intervention in 15 cases (14 patients). The changed consistency of the bone may lead to problems as regards surgical technique and increased loosening of joint prostheses, and the increased bleeding tendency occasionally to hematomas and wound healing disorders or infection. Healing of fractures and consolidation of osteotomies are within normal time limits. Osteotomy corrections have been found durable.