{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T12:12:12Z","timestamp":1767183132565,"version":"3.44.0"},"reference-count":18,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,6,13]]},"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:p>Achondroplasia is a genetic skeletal dysplasia, characterised by dwarfism, with upper and lower limb deformities, that can lead to knee osteoarthritis; the surgical treatment is a challenge due to the particular joint anatomy variances. We present a 40-year-old woman, affected by achondroplasia with severe left knee osteoarthritis; the patient was treated conservatively with poor results. Between the ages of 12 and 17 years, she underwent multiple operative procedures for lower limb lengthening and a partial correction of the valgus deformity, by applying an external fixator. The patient was successfully treated with cemented posterior stabilised, fixed-bearing, total knee arthroplasty. The patient affected by achondroplasia, with severe knee osteoarthritis, should be considered for total joint replacement, which can be carried out with or without additional extra-articular osteotomy for alignment correction. Due to skeletal dysplasia in joint deformities, knee replacement requires careful preoperative planning and special technical considerations.<\/jats:p>","DOI":"10.1136\/bcr-2021-242909","type":"journal-article","created":{"date-parts":[[2021,7,8]],"date-time":"2021-07-08T11:55:11Z","timestamp":1625745311000},"page":"e242909","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Total knee arthroplasty in a young patient with achondroplasia"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3353-1759","authenticated-orcid":false,"given":"Hassan","family":"Zmerly","sequence":"first","affiliation":[{"name":"San Pier Damiano Hospital, Faenza, Italy"},{"name":"UCM Malta, LUDES, Lugano, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Russo","sequence":"additional","affiliation":[{"name":"San Pier Damiano Hospital, Faenza, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manuela","family":"Moscato","sequence":"additional","affiliation":[{"name":"San Pier Damiano Hospital, Faenza, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ibrahim","family":"Akkawi","sequence":"additional","affiliation":[{"name":"Villa Erbosa Hospital, Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,7,8]]},"reference":[{"key":"2025082700221595000_14.7.e242909.1","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1002\/ajmg.a.62018","article-title":"Quality of life in adults with achondroplasia in the United States","volume":"185","author":"Yonko","year":"2021","journal-title":"Am J Med Genet A"},{"key":"2025082700221595000_14.7.e242909.2","doi-asserted-by":"publisher","DOI":"10.1186\/s13023-018-0972-6"},{"key":"2025082700221595000_14.7.e242909.3","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-020-61704-w","article-title":"Lumbar spinal stenosis and disc alterations affect the upper lumbar spine in adults with achondroplasia","volume":"10","author":"Huet","year":"2020","journal-title":"Sci Rep"},{"key":"2025082700221595000_14.7.e242909.4","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2013-008793"},{"key":"2025082700221595000_14.7.e242909.5","first-page":"132","article-title":"Correction of Bowleg deformity in achondroplasia through combined bony realignment and lateral collateral ligament tightening","volume":"14","author":"Kurian","year":"2019","journal-title":"Strat Trauma Limb Reconstr"},{"key":"2025082700221595000_14.7.e242909.6","doi-asserted-by":"crossref","first-page":"1993","DOI":"10.1016\/j.arth.2020.04.007","article-title":"Joint replacements in individuals with skeletal dysplasias: one institution's experience and response to operative complications","volume":"35","author":"Raggio","year":"2020","journal-title":"J Arthroplasty"},{"key":"2025082700221595000_14.7.e242909.7","first-page":"33","article-title":"Two-staged Bilateral, femoral alignment osteotomy with concomitant total knee arthroplasty in an achondroplasia patient - a case report","volume":"7","author":"Walter","year":"2017","journal-title":"J Orthop Case Rep"},{"key":"2025082700221595000_14.7.e242909.8","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.knee.2012.10.012","article-title":"Total knee arthroplasty in a pseudoachondroplastic dwarfism patient with bilateral patellar dislocation","volume":"20","author":"Oh","year":"2013","journal-title":"Knee"},{"key":"2025082700221595000_14.7.e242909.9","doi-asserted-by":"crossref","first-page":"226","DOI":"10.4055\/cios.2019.11.2.226","article-title":"Surgical results of limb lengthening at the femur, tibia, and humerus in patients with achondroplasia","volume":"11","author":"Ko","year":"2019","journal-title":"Clin Orthop Surg"},{"key":"2025082700221595000_14.7.e242909.10","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1007\/s11999-010-1516-0","article-title":"Technical challenges of total knee arthroplasty in skeletal dysplasia","volume":"469","author":"Kim","year":"2011","journal-title":"Clin Orthop Relat Res"},{"key":"2025082700221595000_14.7.e242909.11","doi-asserted-by":"crossref","first-page":"1055","DOI":"10.1016\/j.otsr.2019.04.009","article-title":"Same-stage total knee arthroplasty and osteotomy for osteoarthritis with extra-articular deformity. Part II: femoral osteotomy, prospective study of 6 cases","volume":"105","author":"Catonn\u00e9","year":"2019","journal-title":"Orthop Traumatol Surg Res"},{"key":"2025082700221595000_14.7.e242909.12","doi-asserted-by":"crossref","first-page":"1297","DOI":"10.1016\/j.otsr.2019.06.013","article-title":"Patients with musculoskeletal dysplasia undergoing total joint arthroplasty are at increased risk of surgical site infection","volume":"105","author":"Patel","year":"2019","journal-title":"Orthop Traumatol Surg Res"},{"key":"2025082700221595000_14.7.e242909.13","doi-asserted-by":"crossref","first-page":"2457","DOI":"10.1007\/s00264-012-1695-2","article-title":"One-Stage total knee arthroplasty for patients with osteoarthritis of the knee and extra-articular deformity","volume":"36","author":"Xiao-Gang","year":"2012","journal-title":"Int Orthop"},{"key":"2025082700221595000_14.7.e242909.14","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-199811000-00005"},{"key":"2025082700221595000_14.7.e242909.15","first-page":"39","article-title":"Bilateral total knee arthroplasty in an achondroplastic dwarf 43 years after bilateral tibial osteotomies","volume":"15","author":"Feibel","year":"2002","journal-title":"J Knee Surg"},{"key":"2025082700221595000_14.7.e242909.16","doi-asserted-by":"crossref","first-page":"578","DOI":"10.55095\/achot2011\/091","article-title":"[Total knee arthroplasty in severe valgus deformity in a patient with achondroplasia]","volume":"78","author":"Koudela","year":"2011","journal-title":"Acta Chir Orthop Traumatol Cech"},{"key":"2025082700221595000_14.7.e242909.17","doi-asserted-by":"crossref","first-page":"740","DOI":"10.1016\/j.knee.2020.04.025","article-title":"Total knee arthroplasty in achondroplasia without deformity correction: A case report with 11\u00a0years' follow-up","volume":"27","author":"Bayle-Iniguez","year":"2020","journal-title":"Knee"},{"key":"2025082700221595000_14.7.e242909.18","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2019-233965","article-title":"Customised three-dimensional printed revision acetabular implant for large defect after failed triflange revision cup","volume":"13","author":"Zanasi","year":"2020","journal-title":"BMJ Case Rep"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2021-242909","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T07:22:24Z","timestamp":1756279344000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2021-242909"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7]]},"references-count":18,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2021,7,8]]},"published-print":{"date-parts":[[2021,7]]}},"alternative-id":["10.1136\/bcr-2021-242909"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2021-242909","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2021,7]]}}}