Interview with Gabriel T. Mindler, MD, Pediatric Orthopedic Surgeon, Austria

Who are you and what is your relationship to OI?

I am an orthopedic and trauma surgeon at the Department of Pediatric Orthopedics at the Orthopedic Hospital Speising in Vienna. I am also a member of the Vienna Bone and Growth Center (VBGC), an ERN-designated center specializing in the multidisciplinary treatment of children and adults with rare bone diseases. My clinical expertise lies in assessing and correcting lower limb deformities in both children and adults, with a particular focus on rare bone diseases.

Tell us (briefly) about your past and current work related to OI.

I began specializing in OI under the mentorship of my former boss, Rudolf Ganger. During the final years before his retirement, we collaboratively planned, discussed, and performed all OI surgeries in our department. Alongside Adalbert Raimann (a pediatric endocrinologist at the Medical University of Vienna) and many other colleagues at the Vienna Bone and Growth Center, we have refined the multidisciplinary treatment of children and adults with OI in eastern Austria over the past several years.

OI treatment is highly complex, and my clinical and scientific efforts aim to enhance mobility, improve bone quality, and ultimately improve the quality of life for individuals with OI.

Are you involved in research? How?

Yes, I am actively involved in research. Our recent studies have focused on upper limb movement in individuals with OI (Oder, K., et al., Journal of Clinical Medicine, 2024) and the bone properties of patients with OI type 14, a very rare form of the condition. The study was conducted with Nadja Fratzl-Zelman, Antonella Forlino, Andreas Kranzl, and others. In the future, my research will center on analyzing bone samples from different OI types. I am particularly interested in how these types affect intraoperative bone quality and growth.

Do you belong to any networks/scientific societies?

Yes, I am a member of various national and international societies, including:

• EPOS (European Pediatric Orthopedic Society) “Genetics and Metabolic” study group
• International Osteogenesis Imperfecta Surgeons Study Group
• ISCBH (International Society for Children’s Bone Health)
• GEVR (German Limb Lengthening and Reconstruction Society)
• GAMMA (Gait and Movement Analysis Society for German-speaking countries)
• VKO (Pediatric Orthopedic Society for German-speaking countries)

Additionally, I serve on the medical board of the Austrian XLH Alliance and, as of this year, the OIFE advisory board (medical group). I am also part of the Vienna Bone and Growth Center (VBGC), an ERN-designated network.

How is treatment and care for children and adults with OI organized in your country?

OI care varies between centers. At the Vienna Bone and Growth Center, we have a multidisciplinary team. Children with OI are treated by pediatric endocrinologists (Adalbert Raimann and Gabriele Hartmann) at the Medical University of Vienna. Adults receive care from Prof. Roland Kocijan and Dr. Judith Haschka at the Hanusch Hospital. At the Orthopedic Hospital Speising, our team treats both children and adults.

OI care extends beyond specialized centers, as many trauma and orthopedic departments handle acute fractures for patients with OI. My primary focus is improving awareness and communication within the orthopedic and trauma community in Austria, which I believe is key to enhancing OI care in Austria. Regular follow-ups are essential, especially during growth phases, as fractures and other complications often disrupt treatment plans. Flexibility and vigilance during these periods are crucial.

Major challenges include coordinating multidisciplinary care, managing intraoperative challenges posed by brittle, small bones and severe deformities, and ensuring optimal care both in and outside the hospital. On a positive note, there is significant ongoing research in OI, growing interest among orthopedic surgeons in rare diseases, and advancements in smaller implants, which enable safer corrections of limb deformities in OI.

Personally, maintaining the balance between empathy and avoiding emotional overload remains a challenge for me. However, a team approach ensures the best treatment setting for both families and the multidisciplinary team.

Are you working with the national OI organization in your country? How?

Yes, our center collaborates with the national OI organization. We share updates on new projects and involve them in the design of future studies.

What are the biggest knowledge gaps in OI? How can we address them?

A significant knowledge gap lies in understanding intraoperative bone quality and its correlation with OI type and treatment outcomes. Additionally, we need to deepen our understanding of deformity corrections and the factors contributing to treatment failures.

What do you do in your spare time? Any hobbies/interests/passions?

With two small children at home, I have limited time for hobbies. However, I enjoy visiting Viennese coffee houses and find great relaxation in logging (tree felling) with my brother.

This article has first been published in OIFE Magazine 1-2025