Spontaneous Osteonecrosis of the Knee: State of the Art

Abstract

Osteonecrosis is a terrible condition that can cause advanced arthritis in a number of joints, including the knee. The three types of osteonecrosis that can affect the knee are secondary, post-arthroscopic, and spontaneous osteonecrosis of the knee (SPONK). Regardless of osteonecrosis classification, treatment for this condition seeks to prevent further development or postpone the onset of knee end-stage arthritis. Joint arthroplasty is the best course of action whenever there is significant joint surface collapse or there are signs of degenerative arthritis. The non-operative options for treatment at the moment include observation, nonsteroidal anti-inflammatory medications (NSAIDs), protective weight bearing, and analgesia if needed. Depending on the severity and type of the condition, operational procedures may include unilateral knee arthroplasty (UKA), total knee arthroplasty (TKA), or joint preservation surgery. Joint preservation techniques, such as arthroscopy, core decompression, osteochondral autograft, and bone grafting, are frequently used in precollapse and some postcollapse lesions, when the articular cartilage is typically unaffected and only the underlying subchondral bone is affected. In contrast, operations that try to save the joint following significant subchondral collapse are rarely successful and joint replacement is required to ease discomfort. This article’s goal is to summarise the most recent research on evaluations, clinical examinations, imaging and various therapeutic strategies for osteonecrosis of the knee, including lesion surveillance, medicines, joint preservation methods, and total joint arthroplasty.

Aseptische Nekrosen des Kniegelenkes

“…[3], gefolgt vom medialen Tibiaplateau und zuletzt von der lateralen Femurkondyle. Die laterale Kondyle ist nicht häufig betroffen und wird auch nur selten beschrieben [1].…”

“…Die postarthroskopischen Osteonekrosen (PAONK) stellen eine weitere Kategorie der Osteonekrose des Kniegelenks dar, die sich von SPONK und sekundären Osteonekrosen unterscheiden. Sie kommen selten nach Gelenkspiegelungen vor und wurden erstmals 1991 von Brahme et al beschrieben [1,13].…”

“…Osteonekrosen am Kniegelenk treten auf ▪ spontanspontane Osteonekrosen des Kniegelenks (SPONK), ▪ sekundär und ▪ als postarthroskopisch spontane Osteonekrosen des Kniegelenks (PAONK) [1].…”

“…Demnach bleiben frühe Stadien oft unentdeckt. Patienten mit SPONK klagen häufig über einen akuten Schmerz im Knie und fehlendes vorangegangenes Trauma [1].…”

Network pharmacological analysis on the mechanism of Coix seed decoction for osteoarthritis of the knee

“…[12] Oral NSAIDs, joint cavity injections, and surgical procedures make up the majority of the existing KOA therapeutic options. [13,14] However, pharmacological side effects, infections, and financial burden make it difficult to successfully focus KOA long-term therapy and prevention. [15,16] Therefore, to lessen the health burden linked to KOA, the search for a more affordable and effective treatment approach has become essential.…”