Spontaneous collapse of the tibial plateau: radiological staging

Carpintero, Pedro; Leon, F Escobedo-diaz De; Zafra, Manuel; Montero, Rodolfo Crespo; Carreto, Arturo Cabeza

doi:10.1007/s00256-005-0926-7

Cited by 19 publications

(20 citation statements)

References 12 publications

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“…SPONK affecting both the MFC and MTP has not been reported. Carpintero et al [2] described four patients with simultaneous involvement of the femoral condyle and the tibial plateau. However, their radiologic features were not included.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous osteonecrosis of the knee involving both the medial femoral condyle and the medial tibial plateau: report of three cases

Jung

Lee

Hwang

et al. 2008

Knee Surg Sports Traumatol Arthr

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Spontaneous osteonecrosis of the knee (SPONK) usually involves a single condyle or plateau. The medial femoral condyle (MFC) is most often involved and spontaneous osteonecrosis of the medial tibial plateau (MTP) is a rare condition, representing only 2% of all necroses reported in the knee. SPONK involving both the MFC and the MTP is extremely rare. SPONK occurring in either the MFC or the MTP individually might extend to the corresponding side of the knee in the advanced end-stage; however, in that situation, significant degenerative changes would exist and it might be difficult to differentiate end-stage SPONK form severe osteoarthritis. SPONK affecting both the MFC and the MTP without significant secondary osteoarthritic changes has not been reported, even though it is difficult to know which occurs first. We have cared for three patients with histologically proven osteonecrosis of the MFC and MTP and report their radiologic features.

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Section: Discussionmentioning

confidence: 99%

Spontaneous osteonecrosis of the knee involving both the medial femoral condyle and the medial tibial plateau: report of three cases

Jung

Lee

Hwang

et al. 2008

Knee Surg Sports Traumatol Arthr

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“…There were no age restrictions. The contraindications for OWHTO were: (1) a history of joint infection, (2) symptomatic OA of the lateral compartment or patellofemoral joint, (3) joint instability, (4) FTA > 185°, (5) flexion contracture of > 15°, and (6) extensive collapse of the medial tibial plateau.…”

Section: Methodsmentioning

confidence: 99%

Open-wedge high tibial osteotomy for spontaneous osteonecrosis of the medial tibial plateau shows excellent clinical outcomes

et al. 2020

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PurposeThere have been few reports on medial tibial plateau osteonecrosis, and treatment options remain controversial. This study aimed to evaluate the clinical outcomes of open-wedge high tibial osteotomy (OWHTO) for osteonecrosis of the medal tibial plateau.MethodsPatients who underwent OWHTO for spontaneous osteonecrosis of the medial tibial plateau from November 2013 to September 2017 at our institution and followed up for at least 2 years after surgery were included in this study. Patients with history of alcohol abuse and corticosteroid therapy were excluded. Clinical evaluations, including the Japanese Orthopedic Association (JOA) score and the Oxford Knee Score (OKS), were measured preoperatively and at the final followup. Radiological evaluations included the weight-bearing line ratio (WBLR) and the lesion stage of the osteonecrosis according to Carpintero, Lotke, and the modified Ficat and Arlet classification. The area and size of the necrosis and the type of meniscus tear were also evaluated using preoperative magnetic resonance imaging (MRI). Additionally, cartilage regeneration was evaluated at plate removal.ResultsTwelve cases that underwent OWHTO for spontaneous osteonecrosis of the medial tibial plateau were enrolled. Eleven cases had isolated medial tibial osteonecrosis, and one case had both femoral and tibial osteonecrosis. The mean age was 59.6 ± 9.0 years, and the mean follow-up period was 41.8 ± 17.6 months.The WBLR significantly changed after OWHTO (24.0% ± 10.7% to 66.3% ± 6.7%, P < 0.001), and all clinical scores significantly improved after surgery: JOA score 63.3 ±12.3 to 95.0 ± 4.8, OKS 27.4 ± 7.8 to 42.6 ± 4.1, both 0.001. There were no adverse complications requiring additional surgery. The MRI findings revealed that all cases had meniscal lesions in addition to a necrotic lesion. Second-look arthroscopy was performed at plate removal in 11 cases, and cartilage regeneration was observed in 9/11 cases (81.8%).ConclusionsThis study's results demonstrated that OWHTO is an effective procedure for spontaneous osteonecrosis of the medial tibial plateau with respect to subjective and objective clinical outcomes.

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“…Radiographic evaluation showed stage III changes (Carpintero et al). 1 The medial tibial condyle on right side showed significant bone loss, tibial subluxation and varus deformity with degenerative changes (Fig. 1).…”

Section: Case Reportmentioning

confidence: 97%

Every Knee is not Osteoarthritic, Spontaneous Avascular Necrosis of the Medial Tibial Condyle

Kumar¹,

Yadav²,

Yadav³

et al. 2016

Journal of Postgraduate Medicine, Education and Research

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Avascular necrosis (AVN) of tibial condyles is an uncommon cause of joint degeneration and it may mimic osteoarthritis. The differentiation between spontaneous and secondary osteonecrosis is important for appropriate management. We present here a case of spontaneous avascular necrosis of the medial tibial condyle causing sudden increase in pain; localization to the medial tibial condyle near joint line with exacerbation on weightbearing and varus deformity. We also aim to recapitulate briefly various types and currently available treatment options. In the present case, considering advanced stage of AVN and associated degenerative changes, total knee replacement (TKR) was performed successfully with good outcomes.

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Spontaneous collapse of the tibial plateau: radiological staging

Abstract: The radiological evolution of the disease appears to follow a four-stage course over a period of roughly one year from the onset of symptoms.

Cited by 19 publications

References 12 publications

Spontaneous osteonecrosis of the knee involving both the medial femoral condyle and the medial tibial plateau: report of three cases

Spontaneous osteonecrosis of the knee involving both the medial femoral condyle and the medial tibial plateau: report of three cases

Open-wedge high tibial osteotomy for spontaneous osteonecrosis of the medial tibial plateau shows excellent clinical outcomes

Every Knee is not Osteoarthritic, Spontaneous Avascular Necrosis of the Medial Tibial Condyle

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