Zoledronic acid is more efficient than ibandronic acid in the treatment of symptomatic bone marrow lesions of the knee

Müller, Fabio; Appelt, Konrad; Meier, Christian; Suhm, Norbert

doi:10.1007/s00167-019-05598-w

Cited by 19 publications

(21 citation statements)

References 21 publications

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“…The present prospective study was carried out using a single dose of zoledronic acid in patients diagnosed with BMES in three anatomical regions (hip, knee, and foot/ankle). Our results are similar to those from previously published studies done with other bisphosphonates [ 6 - 7 , 9 ]. Zoledronic acid has the benefit of being administrated intravenously once per year, has a low cost, and has no severe adverse effects.…”

Section: Discussionsupporting

confidence: 93%

“…In our prospective study, we found that a single dose of intravenous zoledronic acid, combined with partial weight-bearing, provided a good response for both clinically and radiographic outcomes in patients with BMES [ 5 , 7 , 9 ]. Numerous studies have assessed the clinical and radiological characteristics of the BMES.…”

Section: Discussionmentioning

confidence: 99%

“…Numerous studies have assessed the clinical and radiological characteristics of the BMES. They showed a clear predominance of male patients [ 5 , 7 , 9 - 10 ], and the vast majority of the lesions were described in the lower extremities, with the proximal site of the femur being the most common anatomical location, followed by the knee and the foot/ankle [ 2 , 10 - 12 ]. In contrast, in our study, we found a female predominance with a male-to-female ratio of 1:1.84.…”

Section: Discussionmentioning

confidence: 99%

“…To date, studies carried out using bisphosphonates on BMES are mostly retrospective. Numerous bisphosphonates, such as zoledronic acid, alendronate, or ibandronate, have been used in a small number of patients [ 2 , 6 - 7 , 9 ]. The present prospective study was carried out using a single dose of zoledronic acid in patients diagnosed with BMES in three anatomical regions (hip, knee, and foot/ankle).…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have shown that although zoledronic acid is effective in completely reversing the clinical process of the disease, its efficacy may be observed late (from four weeks for the reduction of the pain and 14 weeks to 12 months for the complete resolution of pain) [ 2 , 6 , 9 ]. In a study by Muller et al, 12 patients with symptomatic bone marrow lesion of the knee were treated with intravenous zoledronic acid once only, and a complete resolution of the symptoms was observed in 11 patients (92%) four weeks after the application of the medication [ 9 ]. Similarly, a single dose of 5 mg of zoledronic acid in 17 patients with primary BMES in the ankle showed pain reduction in 15 patients (88%) at three months and complete disappearance of the pain in 13 patients (76.4%) after 12 months [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

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Single-Dose Therapy of Zoledronic Acid for the Treatment of Primary Bone Marrow Edema Syndrome

Vasiliadis¹,

Zidrou²,

Charitoudis³

et al. 2021

Cureus

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Objective To review the patients diagnosed with bone marrow edema syndrome who had been treated with one single dose of zoledronic acid. Methods The data of 54 patients with bone marrow edema syndrome treated with a single dose of intravenous zoledronic acid and partial weight-bearing were included in the study. The diagnosis was based on clinical examination, the existence of prolonged pain, the presence of bone marrow edema on magnetic resonance imaging, and the patient's medical history. The efficacy was assessed using changes in symptoms, visual analogue scale, and changes in magnetic resonance imaging. Results Overall, 54 patients (35.2% male) were included with bone marrow edema syndrome, with a mean age of 52.7 ± 9.77 years (range: 35-74 years). The most commonly affected joint was the knee in 32 patients (59.2%), followed by the foot/ankle in 13 patients (24.1%), and the hip in nine patients (16.7%). Improved mobility was reported by 29 patients (53.7%) among the total number of the patients at the six-month follow-up visit. The mean visual analogue scale was 6.77 ± 0.83, 7.25 ± 1.19, and 7.46 ± 0.96 at baseline and 5.11 ± 2.14, 4.25 ± 1.84 and 5.15 ± 2.03 at the six-month follow-up for the hip, knee and foot/ankle, respectively (p = 0.098, p < 0.001, p = 0.002). At the six-month follow-up, the MRI showed resolution of the edema in 20 out of 54 patients (approximately 37%). Only 7.4% of the patients reported minor adverse events which were resolved through a single administration of paracetamol. Conclusion Our data show that the combination treatment of a single dose of zoledronic acid and partial weight-bearing for one month improves mobility and reduces edema in patients with bone marrow edema syndrome in the primary weight-bearing joints.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Single-Dose Therapy of Zoledronic Acid for the Treatment of Primary Bone Marrow Edema Syndrome

Vasiliadis¹,

Zidrou²,

Charitoudis³

et al. 2021

Cureus

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Bone Marrow Edema

Berruto

Tradati

Usellini

2021

Joint Function Preservation

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Atraumatisches Knochenmarködem des Kniegelenks

Münch,

Ackermann,

Deichsel

et al. 2024

Arthroskopie

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ZusammenfassungDas Knochenmarködem (KMÖ) beschreibt ein Phänomen in der Magnetresonanztomographie (MRT), das sich durch eine Hypointensität auf T1-gewichteten Bildern und eine Hyperintensität auf STIR- oder fettunterdrückten T2-gewichteten Bildern auszeichnet. Das KMÖ-Syndrom (KMÖS) ist dabei eine klinisch-radiologische Entität, bei der vorübergehende, unspezifische, subakute oder chronische Gelenkschmerzen in Verbindung mit charakteristischen MRT-Befunden auftreten, jedoch ohne spezifische sekundäre Ursachen. Pathophysiologisch wird angenommen, dass es durch eine venöse Abflussbehinderung zu Ödemen, erhöhtem intraossärem Druck und schließlich zu einer Beeinträchtigung des arteriellen Zuflusses kommt, was konsekutiv zu einer intraossären Ischämie und Nekrose führen kann. In der Regel gilt das KMÖ als selbstlimitierend über einen Zeitraum von 3 bis zu 18 Monaten. Therapeutische Maßnahmen zur Verkürzung des Verlaufs umfassen allen voran die Entlastung des betroffenen Gelenks für 6 bis 8 Wochen abhängig von Symptomen und radiologischen Verlaufskontrollen. Supportiv können Schmerzmittel und entzündungshemmende Medikamente eingenommen werden. Weitere konservative Behandlungsansätze umfassen die Therapie mit extrakorporalen Stoßwellen oder gepulsten elektromagnetischen Feldern sowie pharmakologische Ansätze wie die Off-label-Gabe von Bisphosphonaten, Prostacyclin-Analoga oder Denosumab. Operative Interventionen wie die Core-Dekompression, perkutane Anbohrung oder Subchondroplastik sollten nur in therapierefraktären Fällen nach Versagen konservativer Maßnahmen erwogen werden.

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Zoledronic acid is more efficient than ibandronic acid in the treatment of symptomatic bone marrow lesions of the knee

Cited by 19 publications

References 21 publications

Single-Dose Therapy of Zoledronic Acid for the Treatment of Primary Bone Marrow Edema Syndrome

Single-Dose Therapy of Zoledronic Acid for the Treatment of Primary Bone Marrow Edema Syndrome

Bone Marrow Edema

Atraumatisches Knochenmarködem des Kniegelenks

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