Archives of Orthopaedic and Trauma Surgery

, Volume 125, Issue 1, pp 51–55 | Cite as

Factor V Leiden and the prothrombin 20210A gene mutation and osteonecrosis of the knee

  • Anders Björkman
  • Isabella M. Burtscher
  • Peter J. Svensson
  • Andreas Hillarp
  • Jack Besjakov
  • Göran Benoni
Original Article



The pathogenesis behind osteonecrosis of the knee is still unknown. Circulatory impairment of the bone secondary to thrombosis in the microcirculation has been suggested as a mechanism. The purpose of this study was to examine the association between osteonecrosis of the knee and abnormalities in the thrombotic pathway in the form of factor V Leiden and the prothrombin 20210A gene mutation.

Materials and methods

Thirty-eight consecutive patients (13 men and 25 women) with osteonecrosis of the knee without a history of knee trauma or surgery to the knee were enrolled in this study. Assays for the detection of factor V Leiden and the prothrombin 20210A gene mutation were performed, and the results were compared with those from 282 healthy volunteers.


Six patients were diagnosed with secondary osteonecrosis, four corticosteroid-induced and two alcohol-induced. In 32 patients, no aetiological factor was found, and these patients were diagnosed with primary osteonecrosis of the knee. Twelve patients had 14 gene mutations, 11 factor V Leiden and 3 prothrombin 20210A gene mutations. Factor V Leiden and the prothrombin 20210A gene mutation occurred significantly (p=0.006) more frequently in patients with osteonecrosis than in a population of 282 healthy volunteers (odds ratio 3.1, 95%CI 1.4–6.6).


The results of this study suggest that coagulation abnormalities in the form of factor V Leiden and the prothrombin 20210A gene mutation might play a role in osteonecrosis of the knee.


Osteonecrosis Knee Factor V Leiden Prothrombin gene 



This study was supported by grants from Herman Järnhardts Foundation. The above study complies with the current laws of Sweden.


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Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • Anders Björkman
    • 1
    • 6
  • Isabella M. Burtscher
    • 2
  • Peter J. Svensson
    • 3
  • Andreas Hillarp
    • 4
  • Jack Besjakov
    • 5
  • Göran Benoni
    • 1
  1. 1.Department of OrthopaedicsUniversity Hospital MalmöMalmöSweden
  2. 2.Department of RadiologyUniversity Hospital LundLundSweden
  3. 3.Department of Coagulation DisordersUniversity Hospital MalmöMalmöSweden
  4. 4.Department of Clinical ChemistryUniversity Hospital MalmöMalmöSweden
  5. 5.Department of RadiologyUniversity Hospital MalmöMalmöSweden
  6. 6.Department of Hand SurgeryUniversity Hospital MalmöMalmöSweden

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