Treatment options for secondary osteonecrosis of the knee.
Hassan ZmerlyManuela MoscatoIbrahim AkkawiRiccardo GallettiValentina Di GregoriPublished in: Orthopedic reviews (2022)
Knee osteonecrosis is a debilitating progressive degenerative disease characterized by subchondral bone ischemia. It can lead to localized necrosis, tissue death, and progressive joint destruction. For this reason, it is essential to diagnose and treat this disease early to avoid subchondral collapse, chondral damage, and end-stage osteoarthritis, where the only solution is total knee arthroplasty. Three types of knee osteonecrosis have been documented in the literature: spontaneous or primitive, secondary, and post arthroscopy. Spontaneous osteonecrosis is the most common type studied in the literature. Secondary osteonecrosis of the knee is a rare disease and, unlike the spontaneous one, involves patients younger than 50 years. It presents a particular set of pathological, clinical, imaging, and progression features. The management of secondary osteonecrosis is determined by the stage of the disorder, the clinical manifestation, the size and location of the lesions, whether the involvement is unilateral or bilateral, the patient's age, level of activity, general health, and life expectancy. This review aims to present the recent evidence on treatment options for secondary osteonecrosis of the knee, including conservative treatment, joint preserving surgery, and knee replacement.
Keyphrases
- total knee arthroplasty
- total hip
- knee osteoarthritis
- anterior cruciate ligament
- systematic review
- multiple sclerosis
- anterior cruciate ligament reconstruction
- end stage renal disease
- healthcare
- public health
- case report
- rheumatoid arthritis
- climate change
- ejection fraction
- oxidative stress
- peritoneal dialysis
- minimally invasive
- chronic kidney disease
- high resolution
- bone mineral density
- acute coronary syndrome
- prognostic factors
- social media
- coronary artery bypass
- solid state
- photodynamic therapy
- replacement therapy