Article published Open Source in: Acta Orthopaedica 2021; 92 (5): 608–61
Authors: Ralph J SAKKERS 1, Kathleen MONTPETIT 2, Argerie TSIMICALIS 2,3, Thomas WIRTH 4, Marjolein VERHOEF 1,
Reginald HAMDY 2, Jean A OUELLET 2, Rene M CASTELEIN 1, Chantal DAMAS 2, Guus J JANUS 5,
Wouter H NIJHUIS 1, Leonardo PANZERI 6, Simona PAVERI 6, Dagmar MEKKING 7, Kelly THORSTAD 2,
and Richard W KRUSE 8
Content:
Key Recommendations:
- Interdisciplinary Approach: Surgical decisions should involve patients, families, and a team of healthcare professionals, considering health literacy, cultural beliefs, and support systems.
- Surgical Decision-Making: A transparent partnership between patients, families, and care teams is essential, with clear communication about goals, expectations, and available resources.
- Surgical Techniques: Guidelines include using intramedullary rods for stabilization, avoiding oversized implants, and addressing deformities specific to OI.
- Postoperative Feedback: A standardized feedback loop comparing pre- and postoperative outcomes to refine practices and support global research.
Focus Areas:
- Addressing functional needs, managing comorbidities, optimizing bone quality, and ensuring a supportive infrastructure for surgery and rehabilitation.
- Specific guidelines for different body regions (spine, upper, and lower extremities) and considerations for surgical planning and postoperative care.
Patient-Centered Care:
- Emphasis on aligning surgical goals with patient preferences and cultural contexts.
- Use of tools like the Key4OI Standard Set of Core Outcome Measures for monitoring outcomes and enhancing value-based healthcare.
Challenges and Adaptations:
Addressing complications like rod migration, scoliosis progression, and cranio-cervical deformities.
Managing the variability in OI presentation and balancing surgical timing, technique, and patient readiness.
Key Take Aways:
1.Involvement: Patients and families play an essential role in deciding surgical goals and plans.
2. Supportive Team: A team of experts works together to ensure the best outcomes.
3. Focus on Recovery: After surgery, patients receive ongoing care and therapy to regain function and improve their quality of life.