Hip and Knee Arthroplasty in Patients with Mucopolysaccharidosis: A Systematic Review 

Kimon Toumazos1, Nicole Williams2, *
1 Central Adelaide Local Health Network (CALHN), University of Adelaide, Adelaide, Australia
2 Adelaide Women’s and Children’s Hospital, University of Adelaide, Adelaide, Australia

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Creative Commons License
© 2023 Toumazos and Williams.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Adelaide Women’s and Children’s Hospital, University of Adelaide, Adelaide, Australia; Tel: 0409833529; Email:



To review the use of knee and hip arthroplasty for patients with mucopolysaccharidoses (MPS) to inform clinicians and patients of this emerging area of orthopaedic practice and direct future studies.

Patients and Methods:

An Embase database review was conducted according to Preferred Reporting Item for Systematic Reviews and Meta-analyses (PRISMA) guidelines to identify relevant published articles. Extracted information included demographic data, indications for surgery, surgical details, post-operative outcomes and complications.


Ten articles reported 15 patients with a total of 5 knee and 20 hip arthroplasties were identified and included. The mean age was 28.3 years and mean follow up duration for knee and hip arthroplasties was 3.6 years and 5.1 years respectively. Indications for surgery included pain in all patients, reduced range of motion, genu valgum and joint instability. Complex arthroplasty techniques were required including extensive soft tissue releases, instrumentation modification, screw fixation and modular/dysplasia arthroplasty components. There were four intra-operative fractures in hip arthroplasty patients and one hip arthroplasty underwent revision due to loosening. Pain resolution was documented for all knee arthroplasties and 90% of hip arthroplasties, whilst complications occurred in 9/20 (45%) of all arthroplasties.


Arthroplasty surgery in this rare patient group can be successfully performed for pain relief and improvement in function with careful pre-operative planning and multidisciplinary management. Treating teams should be encouraged to share their experience to contribute to our understanding of indications, technique and outcomes for arthroplasty procedures in MPS patients.

Keywords: Arthroplasty, Joint replacement, Mucopolysaccharidosis, Hip, Knee, Surgery.