title: Orthopaedic manifestations of chronic graft-versus-host disease.
abstract: Chronic graft-versus-host disease (GVHD) is a well-recognized complication of allogeneic bone marrow transplantation (BMT). Musculoskeletal manifestations include joint contractures, polymyositis, polyserositis, and fasciitis. We present 14 patients with orthopaedic complications of chronic GVHD. Long-term conservative management of joint contractures with physical therapy and orthotics was generally successful in restoring patients' premorbid functional status. Surgical release of joint contractures yielded poor results and rendered the affected joints unresponsive to further conservative treatment. Surgical intervention in the treatment of joint contractures resulting from chronic GVHD does not appear qualitatively to improve functional status in patients affected with this disease process.
authors.affiliation: Division of Orthopaedic Surgery, Children's Hospital of Philadelphia, Pennsylvania, USA.
authors.forename: P K
authors.initials: PK
authors.lastname: Beredjiklian
authors.forename: D S
authors.initials: DS
authors.lastname: Drummond
authors.forename: J P
authors.initials: JP
authors.lastname: Dormans
authors.forename: R S
authors.initials: RS
authors.lastname: Davidson
authors.forename: G T
authors.initials: GT
authors.lastname: Brock
authors.forename: C
authors.initials: C
authors.lastname: August
mesh_terms: D000293:Adolescent; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D016026:Bone Marrow Transplantation / Q000009:adverse effects; D002648:Child; D002908:Chronic Disease; D003286:Contracture / Q000209:etiology* / Q000601:surgery* / Q000628:therapy; D016572:Cyclosporine / Q000627:therapeutic use; D005260:Female; D006086:Graft vs Host Disease / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007223:Infant; D008297:Male; D009140:Musculoskeletal Diseases / Q000209:etiology / Q000628:therapy; D009989:Orthotic Devices; D026741:Physical Therapy Modalities; D011241:Prednisone / Q000627:therapeutic use; D012189:Retrospective Studies; D011795:Surveys and Questionnaires
chemical_list: D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D011241:Prednisone