Orthopaedic manifestations of chronic graft-versus-host disease

Chronic graft-versus-host disease (GVHD) is a well-recognized complication of allogeneic bone marrow transplantation (BMT). Musculoskeletal manifestat ions include joint contractures, polymyositis, polyserositis, and fasciitis . We present 14 patients with orthopaedic complications of chronic GVHD. Lo ng-term conservative management of joint contractures with physical therapy and orthotics was generally successful in restoring patients' premorbid fu nctional status. Surgical release of joint contractures yielded poor result s and rendered the affected joints unresponsive to further conservative tre atment. Surgical intervention in the treatment of joint contractures result ing from chronic GVHD does not appear qualitatively to improve functional s tatus in patients affected with this disease process.