Spontaneous Osteonecrosis of the Medial Femoral Condyle

Cleland, Leslie G.; Bowey, R. R.; Henderson, D. R. F.; Milazzo, Stefania

doi:10.5694/j.1326-5377.1976.tb134414.x

Medical Journal of Australia

1976

DOI: 10.5694/j.1326-5377.1976.tb134414.x

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Spontaneous Osteonecrosis of the Medial Femoral Condyle

Leslie G. Cleland

R. R. Bowey

D. R. F. Henderson

et al.

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Cited by 4 publications

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“…On plain radiographs, SONK initially appears as a flattening of the femoral condyle and progresses to a radiolucent osteochondral defect adjacent to the weightbearing area, typically involving the medial femoral condyle. 8,28 On magnetic resonance imaging (MRI), SONK lesions appear as a focal, low-signal finding with linear features in the subarticular bone of the epiphysis. 28 The exact cause of SONK remains unknown.…”

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confidence: 99%

Fresh Osteochondral Allograft Transplantation for Spontaneous Osteonecrosis of the Knee: A Case Series

Tírico

Early

McCauley

et al. 2017

Orthopaedic Journal of Sports Medicine

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Background:Spontaneous osteonecrosis of the knee (SONK) is a clinical entity identified by acute knee pain usually associated with joint effusion, with radiographic findings of a radiolucent defect on the weightbearing area of the femoral condyle. Conservative treatment is initially undertaken; however, surgical procedures are often necessary. Historically, surgical options have included core decompression, cartilage repair, high tibial osteotomy, or joint arthroplasty. Few studies in the literature have reported the use of fresh osteochondral allograft (OCA) for the treatment of SONK lesions.Hypothesis:OCA transplantation is an effective treatment for SONK lesions on the medial femoral condyle.Study Design:Case series; Level of evidence, 4.Methods:A case series was analyzed of 7 patients treated with OCA for large SONK lesions of the medial femoral condyle with a minimum 4-year follow-up. All patients experienced failure of at least 6 months of conservative treatment and declined arthroplasty as the form of definitive treatment for medial femoral condyle lesion. All patients underwent OCA of the medial femoral condyle. Mean lesion size was 4.6 cm2 (range, 3.24-6.25 cm2), with a mean condylar width of 41.7 mm (range, 35.4-48.6 mm), resulting in a median proportion (lesion size/condylar width) of 56.8% (range, 32.7%-62.6%). The median surface allograft area was 5.1 cm2 (range, 3.2-6.3 cm2).Results:The median follow-up was 7.1 years (range, 4.5-14.1 years). No patient had additional surgery following OCA transplant; the allograft failure rate was 0%. Subjective outcome scores from the International Knee Documentation Committee, Knee injury and Osteoarthritis Outcome Score, and modified Merle d’Aubigné-Postel scale improved from preoperative assessment to the latest follow-up. All patients were extremely satisfied with the results of the OCA transplant.Conclusion:Fresh OCA transplantation demonstrated excellent efficacy, durability, and satisfaction in this group of patients with isolated stage 2 and 3 SONK lesions who had experienced failure of conservative treatment. Fresh osteochondral allografts are an attractive method for surgical management of selected patients with spontaneous osteonecrosis of the knee.

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mentioning

confidence: 99%

Fresh Osteochondral Allograft Transplantation for Spontaneous Osteonecrosis of the Knee: A Case Series

Tírico

Early

McCauley

et al. 2017

Orthopaedic Journal of Sports Medicine

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Spontaneous Osteonecrosis of the Knee in Macaca mulatta

et al. 2009

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Natural history of spontaneous osteonecrosis of the knee (SONK): A review

Houpt

Pritzker

Alpert

et al. 1983

Seminars in Arthritis and Rheumatism

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Spontaneous Osteonecrosis of the Medial Femoral Condyle

Cited by 4 publications

References 4 publications

Fresh Osteochondral Allograft Transplantation for Spontaneous Osteonecrosis of the Knee: A Case Series

Fresh Osteochondral Allograft Transplantation for Spontaneous Osteonecrosis of the Knee: A Case Series

Spontaneous Osteonecrosis of the Knee in Macaca mulatta

Natural history of spontaneous osteonecrosis of the knee (SONK): A review

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