| Intervention / management | Indication / goal | Evidence / outcomes (quantitative when available) | Notes / implementation details | Suggested MAXO term(s) | Citations |
|---|---|---|---|---|---|
| NSAIDs / anti-inflammatory medication | Symptom relief for joint pain and stiffness; reduce pain from early degenerative joint disease | Supportive care is standard in case reports/reviews; quantitative MED-specific response rates were not reported in the retrieved evidence. Dikova 2024 explicitly lists anti-inflammatory drugs as part of management. | Used as part of conservative management alongside rehabilitation and lifestyle measures; appropriate for chronic pain flares and osteoarthritis-related symptoms rather than disease modification. | anti-inflammatory drug administration; pain management | (pqac-00000005, pqac-00000047) |
| Physiotherapy / rehabilitation | Maintain mobility, muscle strength, gait function, and joint range of motion | Recommended in conservative management; no MED-specific effect sizes were reported in the retrieved sources. | Often combined with pain management, posture guidance, and orthopedic follow-up; useful across lifespan because physical HRQoL declines with age in MED. | physical therapy; rehabilitation therapy | (pqac-00000005, pqac-00000026, pqac-00000047) |
| Activity modification and weight management | Reduce joint loading and slow symptom progression in weight-bearing joints | Recommended as pragmatic supportive care; no direct interventional MED outcome trial identified. | Particularly relevant because hips and knees are heavily affected and early osteoarthritis is common; often implemented with NSAIDs and physiotherapy. | lifestyle modification; weight reduction counseling; activity modification | (pqac-00000005, pqac-00000047) |
| Guided growth / hemiepiphysiodesis / temporary epiphysiodesis for genu valgum | Correct lower-limb malalignment during growth, especially genu valgum | In the 2025 cohort, surgical procedures included bilateral femur hemiepiphysiodesis and bilateral medial distal femur guided growth with tension-band plates for genu valgum; overall 7/25 genetically resolved patients (28%) underwent orthopedic surgery. Dikova 2024 reports temporary medial epiphysiodesis with hinge plates/screws for valgus deformity. | Best suited to skeletally immature patients with open physes; real-world implementation includes plates/screws or tension-band plates. Outcomes were described qualitatively rather than with standardized angular correction data in retrieved text. | hemiepiphysiodesis; guided growth procedure; lower limb deformity correction | (pqac-00000006, pqac-00000011, pqac-00000002) |
| Proximal femoral osteotomy / distal femoral correction osteotomy | Correct coxa/proximal femoral deformity or distal femoral malalignment; improve gait and joint mechanics | The 2025 cohort reported 2 proximal femoral osteotomies and 2 distal femoral correction osteotomies with plate fixation among operated patients; quantitative pre/post functional scores were not reported for these procedures. | Used in real-world orthopedic management for progressive deformity and symptomatic malalignment. Often individualized based on hip/knee morphology and growth status. | femoral osteotomy; corrective osteotomy | (pqac-00000006, pqac-00000011) |
| Bernese periacetabular osteotomy (PAO) | Joint-preserving treatment for acetabular dysplasia / hip undercoverage and early hip osteoarthritis | In 6 hips from 3 patients, mean age 14.3 years, mean follow-up 1.7 years: LCEA improved 3.8°→47.1° (p=0.02), ACEA 7.3°→35.1° (p=0.02), acetabular index 27.8°→14.6° (p=0.04), femoral head coverage 66.8%→100% (p=0.02), and Harris Hip Score 67.3→86.7 (p=0.05). No major complications reported; all osteotomies united by 6 months. | Staged bilateral PAO was performed with average 104-day interval; immediate rehab with toe-touch ambulation, weight-bearing as tolerated at 1 month, full weight-bearing by 6 months. Image-based tables with these outcomes were retrieved. | periacetabular osteotomy; hip preservation surgery | (pqac-00000009, pqac-00000010, pqac-00000008, pqac-00000016, pqac-00000017) |
| Total hip arthroplasty (THA) | End-stage hip osteoarthritis / severe pain and functional limitation | In the 2025 cohort, 1 patient underwent total hip arthroplasty; quantitative implant survival or PROM data were not reported. Adult MED is associated with premature hip OA and joint replacement may be required relatively young. | Represents salvage treatment after progressive degenerative joint disease. Often follows years of dysplasia-related abnormal loading. | total hip arthroplasty; joint replacement surgery | (pqac-00000006, pqac-00000004, pqac-00000027) |
| Spine surveillance and management in skeletal dysplasia care | Detect spinal stenosis, deformity progression, instability, and myelopathy; prevent irreversible neurologic injury | White et al. consensus produced 31 best-practice guidelines. Surveillance recommendations include routine clinical spinal exam plus radiographic follow-up, regular neurological assessment, and further evaluation for any myelopathic signs. Surgical thresholds cited in literature include thoracolumbar kyphosis >60° with >10°/year progression; complication rates in growth-friendly instrumentation reports included dural tear ~30% and neurologic injury ~20%. | Although not MED-specific, guidance is relevant for MED patients with scoliosis/kyphosis or spine symptoms. Pre-op MRI/advanced imaging is recommended for “spine-at-risk” anatomy; avoid prophylactic C1–C2 fusion without cord compression/myelopathy. Conservative measures include posture guidance, bracing/casting for flexible kyphosis, NSAIDs, physical therapy, and timely surgery when progression persists. | spinal monitoring; neurologic monitoring; spinal radiography; magnetic resonance imaging; spinal fusion; spinal decompression | (pqac-00000044, pqac-00000045, pqac-00000047, pqac-00000048, pqac-00000049) |
| Posterior spinal instrumentation and fusion | Treat progressive scoliosis / spinal deformity with instability or neurologic risk | In the 2025 MED cohort, 1 patient underwent posterior spinal instrumentation and fusion; no MED-specific quantitative follow-up metrics were provided. | Should be individualized and informed by skeletal dysplasia spine guidelines, including pre-operative advanced imaging and assessment of cord compression / sagittal balance. | posterior spinal fusion; spinal instrumentation | (pqac-00000011, pqac-00000044, pqac-00000048) |
| Experimental pain therapy related to COMP-spectrum disease: oral resveratrol in pseudoachondroplasia | Reduce joint pain in COMP-related skeletal dysplasia spectrum (related, not MED-specific) | Phase 2 randomized, triple-masked crossover trial NCT03866200 enrolled 6 participants; resveratrol 125 mg/day vs placebo for 90 days with 30-day washout. Primary endpoint: Numeric Pain Rating Scale; secondary endpoint: SF-36. Trial status: TERMINATED due to inability to recruit target number, so no efficacy outcome was established. | Not a MED trial, but relevant because pseudoachondroplasia and COMP-MED share COMP-related pathobiology and pain burden. Suggests translational interest in symptom-modifying therapy for COMP disorders. | resveratrol administration; pain management clinical trial | (pqac-00000012) |


*Table: This table summarizes current treatment and management approaches for multiple epiphyseal dysplasia, including supportive care, orthopedic procedures, spine surveillance, and a related experimental pain trial in the COMP-spectrum disorder pseudoachondroplasia. It emphasizes real-world implementation details and the limited but useful quantitative surgical evidence currently available.*