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Histopathologic findings of spontaneous osteonecrosis of the knee at an early stage: a case report

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Abstract

We histopathologically examined a surgically resected full specimen obtained from an early-stage spontaneous osteonecrosis of the knee (SPONK). On a mid-coronal cut section of the resected medial femoral condyle, a linear fracture line paralleling the subchondral bone endplate was found. Histopathologically, prominent callus formation was seen comprising of reactive woven bone and granulation tissue on both sides of the fracture. Fracture-related bone debris was focally observed at the osteochondral side of the fracture. Definitive features of antecedent bone infarction such as creeping substitution and bone marrow necrosis were not detected. These findings suggested that SPONK was the result of a subchondral fracture rather than primary osteonecrosis.

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References

  1. Ahlbäck S, Bauer GC, Bohne WH. Spontaneous osteonecrosis of the knee. Arthritis Rheum. 1968;11:705–33.

    Article  PubMed  Google Scholar 

  2. Aglietti P, Insall JN, Buzzi R, Deschamps G. Idiopathic osteonecrosis of the knee: aetiology, prognosis and treatment. J Bone Joint Surg (Br). 1983;65:588–97.

    CAS  Google Scholar 

  3. Heyse TJ, Khefacha A, Fuchs-Winkelmann S, Cartier P. UKA after spontaneous osteonecrosis of the knee: a retrospective analysis. Arch Orthop Trauma Surg. 2011;131:613–7.

    Article  PubMed  Google Scholar 

  4. Koshino T. The treatment of spontaneous osteonecrosis of the knee by high tibial osteotomy with and without bone-grafting or drilling of the lesion. J Bone Joint Surg Am. 1982;64(1):47–58.

    CAS  PubMed  Google Scholar 

  5. Lotke PA, Abend JA, Ecker ML. The treatment of osteonecrosis of the medial femoral condyle. Clin Orthop Relat Res. 1982;171:109–16.

    PubMed  Google Scholar 

  6. Cruess RL. Osteonecrosis of bone: current concepts as to etiology and pathogenesis. Clin Orthop Relat Res. 1986;208:30–9.

    PubMed  Google Scholar 

  7. Jones JP. Fat embolism, intravascular coagulation, and osteonecrosis. Clin Orthop Relat Res. 1993;292:294–308.

    PubMed  Google Scholar 

  8. Lotke PA, Ecker ML, Alavi A. Painful knees in older patients: radionuclide diagnosis of possible osteonecrosis with spontaneous resolution. J Bone Joint Surg Am. 1977;59(5):617–21.

    CAS  PubMed  Google Scholar 

  9. Yamamoto T, Bullough PG. Spontaneous osteonecrosis of the knee: the result of subchondral insufficiency fracture. J Bone Joint Surg Am. 2000;82(6):858–66.

    CAS  PubMed  Google Scholar 

  10. Jose J, Pasquotti G, Smith MK, Gupta A, Lesniak BP, Kaplan LD. Subchondral insufficiency fractures of the knee: review of imaging findings. Acta Radiol. 2015;56(6):714–9.

    Article  PubMed  Google Scholar 

  11. Kattapuram TM, Kattapuram SV. Spontaneous osteonecrosis of the knee. Eur J Radiol. 2008;67(1):42–8.

    Article  PubMed  Google Scholar 

  12. Kidwai AS, Hemphill SD, Griffiths HJ. Radiologic case study: spontaneous osteonecrosis of the knee reclassified as insufficiency fracture. Orthopedics. 2005;28(3):236, 333–6.

    PubMed  Google Scholar 

  13. Nakamura N, Horibe S, Nakamura S, Mitsuoka T. Subchondral microfracture of the knee without osteonecrosis after arthroscopic medial meniscectomy. Arthroscopy. 2002;18(5):538–41.

    Article  PubMed  Google Scholar 

  14. Takeda M, Higuchi H, Kimura M, Kobayashi Y, Terauchi M, Takagishi K. Spontaneous osteonecrosis of the knee: histopathological differences between early and progressive cases. J Bone Joint Surg (Br). 2008;90:324–9.

    Article  CAS  Google Scholar 

  15. Mears SC, McCarthy EF, Jones LC, Hungerford DS, Mont MA. Characterization and pathological characteristics of spontaneous osteonecrosis of the knee. Iowa Orthop J. 2009;29:38–42.

    PubMed  PubMed Central  Google Scholar 

  16. Yamamoto T, Schneider R, Bullough PG. Insufficiency subchondral fracture of the femoral head. Am J Surg Pathol. 2000;24(3):464–8.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

This work was partially supported by a Research Grant for Intractable Diseases from Japan Agency for Medical Research and Development, AMED(H26-Itaku(Nan)-Ippan-031), and a research grant from Japan society for the Promotion of Science(15 K10479).

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Hiroyuki Hatanaka, Takuaki Yamamoto, Goro Motomura, Kazuhiko Sonoda & Yukihide Iwamoto

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  1. Hiroyuki Hatanaka
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  2. Takuaki Yamamoto
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  3. Goro Motomura
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  4. Kazuhiko Sonoda
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  5. Yukihide Iwamoto
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Correspondence to Takuaki Yamamoto.

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Hatanaka, H., Yamamoto, T., Motomura, G. et al. Histopathologic findings of spontaneous osteonecrosis of the knee at an early stage: a case report. Skeletal Radiol 45, 713–716 (2016). https://doi.org/10.1007/s00256-016-2328-4

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  • DOI: https://doi.org/10.1007/s00256-016-2328-4

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