
doi: 10.24398/a.413.2022
Introduction : La dysplasie poly��piphysaire pseudorhumato��de (DPP) est une anomalie g��n��tique rare de l���hom��ostasie du cartilage. Par ses multiples ost��o-arthropathies, elle entra��ne un handicap physique grave touchant plusieurs fonctions. Le remplacement proth��tique peut ��tre adopt�� pour traiter l���arthropathie en phase terminale, bien qu����� notre connaissance, il y ait eu peu d�����tudes concernant ses r��sultats fonctionnels. L���objectif de notre travail est de d��crire le retentissement fonctionnel de trois patientes atteintes de DPP apr��s la mise d���une proth��se totale de hanche unilat��rale. Observation : Trois soeurs ��g��es respectivement de 28, 25 et 31 ans pr��sentaient des polyarthralgies d���allure mixte ��voluant depuis l�����ge de 10 ans avec d��formations et limitations articulaires touchant le rachis cervical et lombaire, les petites et grosses articulations avec un retentissement fonctionnel important limitant ainsi leurs activit��s quotidiennes. Le bilan inflammatoire et immunologique ��tait n��gatif. Les radiographies standards montraient des ��largissements m��taphyso-��piphysaires sans destruction articulaire. Les trois s��urs ont b��n��fici�� d���une proth��se totale de la hanche unilat��rale suivies de s��ances de r����ducation au service de m��decine physique et de r��adaptation fonctionnelle avec un gain en amplitudes articulaires, une am��lioration aussi bien de l���indice de Postel-merle d���aubign�� que de l���indice de WOMAC (Western Ontario and McMaster Universities Arthritis Index) mais sans progr��s fonctionnel global. Conclusion : Les multiples raideurs articulaires dans la DPP peuvent ��tre une source d���incapacit�� fonctionnelle non n��gligeable imposant un traitement chirurgical adapt��. Dans notre observation, bien que les deux patientes ont b��n��fici�� d���une proth��se totale de hanche unilat��rale associ��e �� des exercices de r����ducation; qui occupent une place importante dans la prise en charge th��rapeutique ; le r��sultat fonctionnel n�����tait pas satisfaisant suite �� plusieurs facteurs associ��s, d���o�� l���int��r��t d���un diagnostic pr��coce.
Background : Progressive pseudorheumatoid dysplasia (PPD) is a rare genetic disorder of cartilage homeostasis. By its multiple osteoarthropathies, it leads to severe physical disability affecting several functions. Prosthetic joint replacement can be adopted to handle end-stage arthropathy, although, to our knowledge, there have been a few reports concerning functional outcomes after joint replacement.The purpose of this work is to describe the functional impact after unilateral total hip arthroplasty (THA) of three sisters with PPD. Case report : Three sisters aged 28, 25 and 31 years old, had symmetric mixed polyarthralgia starting at the age of 10 years with articular deformation and stiffness of the cervical and lumbar spine, major and minor joints including significant functional consequences that limit their daily activities. Laboratory tests revealed no anomalies. Standard radiographs demonstrate epimetaphyseal enlargement without erosive lesions. The three sisters received unilateral THA followed by rehabilitation sessions at the Department of Physical and Rehabilitation Medicine. Range of motion has been improved as well as the function index Postel-Merle of Aubign�� and the Western Ontario and McMaster Universities Arthritis Index without overall functional progress. Conclusion : PDD usually causes a numerous joint stiffness that may be a source of substantial functional limitations. Therefore, prosthetic joint replacement might be the only way to rebuild a functional joint. In this observation, although the three patients benefited from a unilateral total hip replacement combined with rehabilitation exercises, which hold an important place in therapeutic management; the functional result was not very satisfactory due to several associated factors, hence the importance of early diagnosis.
Dysplasie poly��piphysaire pseudorhumato��de; Retentissement fonctionnel, PTH.
Dysplasie poly��piphysaire pseudorhumato��de; Retentissement fonctionnel, PTH.
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