Disorders Leading to Early-Onset Osteoarthritis: Orthopedic Considerations and Insights

Osteoarthritis (OA), characterized by articular cartilage deterioration, is influenced by factors such as age, trauma, genetic altera- tions, and inflammatory diseases. Early-onset osteoarthritis (EO-OA), typically observed before 40 or 50, can result from genetic mutations affecting connective tissue, inflammatory diseases, or trauma. Genetic syndromes like pseudoachondroplasia or spondy- loepiphyseal dysplasia, along with mutations in collagen genes contribute to early-onset OA development. Disorders like spondyloepiphyseal dysplasia and multiple epiphyseal dysplasia manifest with skeletal anomalies and joint issues, necessitating careful orthopedic management. In conditions like achondroplasia and Stickler syndrome, EO-OA arises due to axis and shape abnormalities rather than primary cartilage problems. Hemophilic arthropathy, characterized by recurrent intra- articular bleeding, requires prophylactic measures and meticulous perioperative management during joint replacement surgeries. Alkaptonuria and chondrocalcinosis lead to cartilage degeneration and tissue damage, requiring caution during orthopedic interven- tions. Inflammatory arthritis, particularly rheumatoid arthritis and ankylosing spondylitis, elevates complication rates post-arthro- plasty. Ehlers–Danlos syndrome (EDS) poses challenges due to tissue fragility and laxity, demanding careful surgical techniques and postoperative care. Each disorder presents unique challenges in orthopedic management, ranging from joint instability to increased infection risks. Patient-specific factors, including genetic predisposition and systemic complications, influence surgical outcomes and implant survival rates. Orthopedic surgeons must tailor interventions to address underlying pathology while minimizing risks associated with each disorder, ensuring optimal patient outcomes and satisfaction.