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Sequential Knee and Hip Arthroplasty in a Patient With Pfeifer-Weber-Christian Disease

Barros Prieto E, Noboa Freile E, Peñaherrera Carillo C, Endara Urresta F, Barros Castro A, Vaca Perez P

Arthroplasty today, 2025

Abstract

Pfeifer-Weber-Christian Disease (PWCD) is a rare chronic inflammatory condition characterized by recurrent painful subcutaneous nodules and systemic manifestations. Long-term corticosteroid therapy, essential for managing PWCD, predisposes patients to complications such as osteoarthritis and avascular necrosis, often necessitating joint replacement surgeries. This report discusses a 38-year-old woman with a 15-year history of PWCD who underwent sequential knee and hip arthroplasty due to severe joint degeneration. The patient presented with debilitating pain, significant functional impairment, and advanced degenerative changes in the left knee and right hip. A multidisciplinary team provided comprehensive perioperative care to address the complexities of chronic inflammation, immunosuppression, and poor bone quality. This case highlights the feasibility of joint replacement in PWCD patients when a multidisciplinary approach and meticulous planning are applied. It underscores the importance of individualized surgical strategies and extended follow-up to optimize outcomes in complex cases.

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