Rheumatology International

, Volume 33, Issue 6, pp 1397–1402

Bisphosphonates or prostacyclin in the treatment of bone-marrow oedema syndrome of the knee and foot

  • Clemens Baier
  • Jens Schaumburger
  • Jürgen Götz
  • Guido Heers
  • Thorsten Schmidt
  • Joachim Grifka
  • Johannes Beckmann
Original Article

DOI: 10.1007/s00296-012-2584-0

Cite this article as:
Baier, C., Schaumburger, J., Götz, J. et al. Rheumatol Int (2013) 33: 1397. doi:10.1007/s00296-012-2584-0

Abstract

Bone-marrow oedema (BME) represents a reversible but mostly painful increase in interstitial fluid. The exact pathogenetic processes still remain unknown. Treatment options are mainly symptomatic with core decompression as golden standard leading to immediate pain relieve. Recently, it has been shown that intravenous prostacyclin and bisphosphonates are useful in achieving a reduction in BME with a considerable improvement in the accompanying symptoms. We compared the outcome of both intravenously applied prostacyclin (Ilomedin®, 10 patients) and bisphosphonate (Bondronat®, 10 patients) in treatment of BME of the knee and foot. We could find a significant improvement of WOMAC score, SF-36 score and VAS 3 months and 1 year after therapeutic intervention in both the prostacyclin and the bisphosphonate group. Concerning the MRI scans in both groups, we found a distinct reduction of BME in 47 % and a complete regression in 40 %. Comparing both groups, the improvement of the scores was greater in the prostacyclin group than in the bisphosphonate group; the difference, however, was not significant. Intravenous bisphosphonates as well as prostacyclin are of efficient therapeutic benefit in treatment of BME with a quicker and greater effect of prostacyclin.

Keywords

Bone-marrow oedema Bisphosphonate Prostacyclin 

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Clemens Baier
    • 1
  • Jens Schaumburger
    • 1
  • Jürgen Götz
    • 1
  • Guido Heers
    • 1
  • Thorsten Schmidt
    • 1
  • Joachim Grifka
    • 1
  • Johannes Beckmann
    • 1
  1. 1.Department of Orthopaedic SurgeryUniversity Hospital of RegensburgBad AbbachGermany

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