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Kortisoninduzierte Osteonekrose des Femurkondylus im Kindesalter

Cortisone-induced avascular osteonecrosis of the femoral condyle in childhood

  • Kasuistiken
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Arthroskopie Aims and scope

Zusammenfassung

Ziel der vorliegenden Kasuistik war es, am Beispiel eines gelenkerhaltenden Vorgehens die Möglichkeiten und Grenzen des seltenen Krankheitsbildes der aseptischen, kortisoninduzierten Osteonekrose im fortgeschrittenen Stadium am distalen Femur bei einem 13-jährigen Jungen mit offenen Wachstumsfugen zu beschreiben. Trotz einer Osteonekrose im Stadium 3–4 nach Soucacos gelang es, durch eine offene, wachstumsfugenschonende Nekroseabtragung und Spongiosaplastik die Osteonekrose ohne sekundäre Wachstumsschäden zum Ausheilen zu bringen, den Gelenkknorpel zu erhalten und eine normale Gelenkfunktion wiederherzustellen.

Abstract

The goal of the present report is to describe a case of cortisone-induced osteonecrosis of the medial femoral condyle in a 13-year-old boy with open growth plates. Despite an advanced stage 3–4 osteonecrosis according to Soucacos, a surgical biological reconstruction procedure including subchondral bone debridement and autologous as well as allogenic bone grafting proved to be successful. After a 2.5-year follow-up the boy has regained normal knee function and no growth disturbances were observed. Magnetic resonance imaging (MRI) revealed normal cartilage as well as a good ingrowth of the subchondral bone.

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Literatur

  1. Anderson M, Green WT, Messner MB (1963) Growth and predictions of growth in the lower extremities. J Bone Joint Surg Am 45:1–14

    PubMed  Google Scholar 

  2. Arico M, Boccalatte MF, Silvestri D et al (2003) Pediatrica. Osteonecrosis: an emerging complication of intensive chemotherapy for childhood acute lymphoblastic leukemia. Haematologica 88:747–753

    PubMed  CAS  Google Scholar 

  3. Clar H, Pascher A, Kastner N et al (2010) Matrix-assisted autologous chondrocyte implantation into a 14 cm(2) cartilage defect, caused by steroid-induced osteonecrosis. Knee 17:255–257

    Article  PubMed  CAS  Google Scholar 

  4. Karimova EJ, Rai SN, Ingle D et al (2006) MRI of knee osteonecrosis in children with leukemia and lymphoma: Part 2, clinical and imaging patterns. Am J Roentgenol 186:477–482

    Article  Google Scholar 

  5. Karimova EJ, Kaste SC (2007) MR imaging of osteonecrosis of the knee in children with acute lymphocytic leukemia. Pediatr Radiol 37:1140–1146

    Article  PubMed  Google Scholar 

  6. Karimova EJ, Wozniak A, Wu J et al (2010) How does osteonecrosis about the knee progress in young patients with leukemia? A 2- to 7-year Study. Clin Orthop Relat Res 468:2454–2459

    Article  PubMed  CAS  Google Scholar 

  7. Mattano LA Jr, Sather HN, Trigg ME, Nachman JB (2000) Osteonecrosis as a complication of treating acute lymphoblastic leukemia in children: a report from the Children’s Cancer Group. J Clin Oncol 18:3262–3272

    PubMed  Google Scholar 

  8. Nakamura J, Saisu T, Yamashita K et al (2010) Age at time of corticosteroid administration is a risk factor for osteonecrosis in pediatric patients with systemic lupus erythematosus. A prospective magnetic resonance imaging study. Arthr Rheum 62:609–615

    Article  Google Scholar 

  9. Nakamura N, Horibe S, Iwahashi T et al (2004) Healing of a chondral fragment of the knee in an adolescent after internal fixation. A case report. J Bone Joint Surg 86-A:2741–2746

    Google Scholar 

  10. Salzman GM, Sah BR, Schmal H et al (2012) Microfracture for treatment of knee cartilage defects in children and adolescents. Pediatr Rep 4(2):e21

    Article  Google Scholar 

  11. Schmal H et al (2012) Autologous chondrocyte implantation in children and adolescents. Knee Surg Sports Traumatol Arthrosc

  12. Soucacos PN, Xenakis TH, Beris AE et al (1997) Idiopathic osteonecrosis of the medial femoral condyle. Classification and treatment. Clin Orthop 82–89

  13. Vora A (2011) Management of osteonecrosis in children and young adults with acute lymphoblastic leukaemia. Br J Haematol 155:549–560

    Article  PubMed  CAS  Google Scholar 

  14. Werner A, Jäger M, Schmitz H, Krauspe R (2003) Joint preserving surgery for osteonecrosis and osteochondral defects after chemotherapy in childhood. Klin Padiatr 215:332–337

    Article  PubMed  CAS  Google Scholar 

  15. Westhoff B, Jäger M, Krauspe R (2008) Osteonekrosen nach Chemotherapie im Kindesalter. Orthopäde 37:56–62

    Article  PubMed  CAS  Google Scholar 

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Interessenkonflikt

Der korrespondierende Autor gibt für sich und seine Koautoren an, dass kein Interessenkonflikt besteht.

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Authors and Affiliations

  1. Dept. of Orthopaedic Surgery, Centre de l’Appareil Locomoteur, de Medecine du Sport et de Prevention, Akademisches Lehrkrankenhaus, Centre Hospitalier, Clinique d’Eich, Universitätskliniken des Saarlandes, 76, rue d’Eich, 1460, Luxembourg, Luxembourg

    R. Seil, M. Najfeld, A. Hoffmann, G. Reyle & D. Pape

  2. Sports Medicine Research Laboratory, Public Research Centre for Health, Centre Médical de la Fondation Norbert Metz, Luxembourg, Luxembourg

    R. Seil & D. Pape

  3. Knorpelnetz der Großregion SaarLorLux, -, -

    R. Seil & D. Pape

Authors
  1. R. Seil
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  2. M. Najfeld
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  3. A. Hoffmann
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  4. G. Reyle
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  5. D. Pape
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Correspondence to R. Seil.

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Seil, R., Najfeld, M., Hoffmann, A. et al. Kortisoninduzierte Osteonekrose des Femurkondylus im Kindesalter. Arthroskopie 25, 280–284 (2012). https://doi.org/10.1007/s00142-011-0686-4

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  • DOI: https://doi.org/10.1007/s00142-011-0686-4

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