Current Rheumatology Reports

, 16:441 | Cite as

Treatment of Osteonecrosis in Systemic Lupus Erythematosus: A Review

  • T. Andrew Ehmke
  • Jeffrey J. Cherian
  • Eddie S. Wu
  • Julio J. Jauregui
  • Samik Banerjee
  • Michael A. MontEmail author
Systemic Lupus Erythematosus (M Petri, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Systemic Lupus Erythematosus


Osteonecrosis (ON) is a devastating illness that can lead to severe joint disease in young patients. The pathogenesis of ON is largely unknown; however, there have been numerous reports associating risk factors including systemic lupus erythematosus (SLE) with the disease. The risk of ON for SLE patients is believed to be a result of both the SLE disease state itself and the concomitant use of corticosteroids. The objective of osteonecrosis treatment is typically to halt progression or delay the onset of end-stage arthritis that may require a total joint arthroplasty (TJA). Joint-preserving procedures are attempted for pre-collapse and some post-collapse lesions. After severe subchondral collapse has occurred, TJA is often necessary to relieve pain. The purpose of this article is to draw attention to recent evidence regarding several treatment options for the management of SLE-associated ON, including lesion observation, medication, joint-preserving techniques, and TJA.


Osteonecrosis Hip Knee Shoulder Joint replacement Joint preservation 


Compliance with Ethics Guidelines

Conflict of Interest

T. Andrew Ehmke, Jeffrey J. Cherian, Eddie S. Wu, Julio J. Jauregui, and Samik Banerjee declare that they have no conflict of interest. Michael A. Mont declares receipt of personal fees and non-financial support from Sage Products, Inc., Stryker, Wright Medical Technology, Inc., DJ Orthopaedics, Joint Active Systems, and TissueGene; personal fees from Biocomposites, Janssen, and Medtronic; and grants from National Institutes of Health (NIAMS & NICHD).

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance

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© Springer Science+Business Media New York 2014

Authors and Affiliations

  • T. Andrew Ehmke
    • 1
  • Jeffrey J. Cherian
    • 1
  • Eddie S. Wu
    • 1
  • Julio J. Jauregui
    • 1
  • Samik Banerjee
    • 1
  • Michael A. Mont
    • 1
    Email author
  1. 1.Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and ReplacementSinai Hospital of BaltimoreBaltimoreUSA

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