Osteonecrosis of the knee.

Lotke, Paul A.; Ecker, Malcolm L.

doi:10.2106/00004623-198870030-00027

Cited by 140 publications

(104 citation statements)

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“…UKA was considered contraindicated in patients with inflammatory arthritis [28], age younger than 50 years, high activity level, patellofemoral pain, exposed bone in the patellofemoral joint or opposite compartment, and secondary osteonecrosis [7,16,25,29,31,32]. From our population, we selected patients with a diagnosis of primary spontaneous osteonecrosis of the knee in the medial compartment on preoperative MRI [11,22,25,35] and intraoperative examination; radiographic diagnosis of Stage 4 osteonecrosis [25-27, 35, 36] with collapse of the medial compartment (Ahlbäck Grades III-IV) [2], and minimum clinical followup of 5 years. We excluded 97 patients with other causes of isolated medial compartment arthritis and those with (1) patellofemoral joint symptoms, (2) lateral joint line pain, (3) previous high tibial osteotomy, (4) morbid obesity (BMI [ 40), (5) diagnosis of inflammatory degenerative joint diseases [28], and (6) previous open or arthroscopic medial meniscectomy [31].…”

Section: Methodsmentioning

confidence: 99%

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Is Unicompartmental Arthroplasty an Acceptable Option for Spontaneous Osteonecrosis of the Knee?

Bruni

Iacono

Raspugli

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background The literature suggests survivorship of unicompartmental knee arthroplasties (UKAs) for spontaneous osteonecrosis of the knee ranges from 93% to 97% at 10 to 12 years. However, these data arise from small series (23 to 33 patients), jeopardizing meaningful conclusions. Questions/purposes We determined (1) the longer-term survivorship of UKAs in a larger group of patients with spontaneous osteonecrosis of the knee; (2) their subjective, symptomatic, and functional outcomes; and (3) the percentage of failures and reasons for failures to identify relevant indications, contraindications, and technical parameters for treatment with a modern implant design. Methods We retrospectively evaluated all 84 patients with late-stage spontaneous osteonecrosis of the knee who had a medial UKA from 1998 to 2005. All patients had preoperative MRI to confirm the diagnosis, exclude metaphyseal involvement, and confirm the absence of major degenerative changes in the lateral and patellofemoral compartments. The mean age of the patients at surgery was 66 years and mean BMI was 28.9. We conducted KaplanMeier survival analysis using revision for any reason as the end point. Minimum followup was 63 months (mean, 98 months; range, 63-145 months). Results Ten-year survivorship was 89%. Ten revisions were performed; the most common reasons were subsidence of the tibial component (four) and aseptic loosening of the tibial component (three). No patient underwent revision for progression of osteoarthritis in the lateral or patellofemoral compartments. Conclusions Our data suggest spontaneous osteonecrosis of the knee may be an indication for UKA, provided secondary osteonecrosis of the knee is ruled out, preoperative

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Section: Methodsmentioning

confidence: 99%

“…Some surgeons believe joint arthroplasty is the only reasonable treatment for late-stage spontaneous osteonecrosis of the knee with secondary joint collapse [1,23,25]. UKA seems to be an appropriate procedure [19,20,33], particularly for patients older than 65 years with unaffected lateral and patellofemoral compartments [19,21,24,35,36].…”

Section: Introductionmentioning

confidence: 99%

Is Unicompartmental Arthroplasty an Acceptable Option for Spontaneous Osteonecrosis of the Knee?

Bruni

Iacono

Raspugli

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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“…Burada olgumuzda osteonekroz ileri evrede olduğu için önerilen konservatif tedavilere yanıt alınamamıştır. Konservatif tedaviye yanıt alınmayan olgularda artroskopik yöntemler, kor dekompresyon, yüksek tibial osteotomi, yüksek tibial osteotomi, total diz artroplastisi gibi cerrahi yöntemler uygulanır (16). Sonuç olarak osteonekroz uzun yıllardır bilinen ve non operatif ve operatif tedavi yöntemleri geliştirilmeye çalışılan bir hastalık olmasına rağmen nedeni tam olarak anlaşılamamıştır.…”

Section: Olguunclassified

A Rare Case of Osteonecrosis Caused by Arthroscopy: A Case Report

Bağcıer¹,

Erdal²,

Onaç³

2016

Tod

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SummaryAvascular necrosis, which is caused by non-traumatic factors, is not a specific disease entity but the final common result of many conditions leading to death of bone cells by the impairment of blood supply. Although associated diseases and conditions (steroid administration, alcoholism, systemic lupus erythematosus, etc.) are well known, avascular necrosis is thought to arise from a multifactorial etiology of mechanical, hormonal and hematologic factors. The goals of treatment are to maintain range of motion, to stop the progression of disease, and to reduce symptoms. If conservative treatment fails, arthroscopic debridement, core decompression, grafting, and arthroplasty are surgical alternatives according to the stage of disease. Keywords: Avascular necrosis, arthroscopy, radiology Nadir Görülen Artroskopi Sonrası Osteonekroz: Bir Olgu Sunumu A Rare Case of Osteonecrosis Caused by Arthroscopy: A Case ReportTravma dışı nedenlerle oluşan avasküler nekroz, kan akımının bozulması sonucu kemik hücrelerinin ölümü ile sonuçlanan bir antitedir. Avasküler nekroza neden olan hastalıklar (steroid kullanımı, alkolizm, sistemik lupus eritematozus vb.) bilinse de, hastalığın patogenezinde mekanik, hormonal ve hematolojik faktörlerin rol oynadığı çok etkenli etiyoloji olduğu düşünülmektedir. Tedavide amaç eklem hareket açıklığını korumak, hastalığın progresyonunu durdurmak ve semptomları azaltmaktır. Konservatif tedaviye yanıtsızlık durumunda hastalığın evresine göre artroskopik debridman, kor dekompresyon, greftleme ve artroplasti uygulanabilir.

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“…Lateral compartment arthrosis may be the major complication of a spontaneous osteonecrosis at the lateral femoral compartment (Lotke and Ecker 1988;Ecker and Lotke 1994). Typically, this clinic condition is presented with an acute onset of pain in women older than 55 years.…”

Section: Osteonecrosismentioning

confidence: 99%