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Joint-preserving surgical treatment of spontaneous osteonecrosis of the knee

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Background

To date, reports of surgical treatment of spontaneous osteonecrosis of the knee (SPONK) refractory to non-operative treatment have primarily focused on knee arthroplasty. This report presents an overview of the characteristics of SPONK and reports our experience with joint-preserving surgical treatment of this condition.

Methods

Fifteen patients who had joint-preserving surgery after failed non-operative modalities were studied. These patients were treated at a single center between January 1998 and September 2006 with a combination of arthroscopy and core decompression, or osteochondral autograft transfers.

Results

Thirteen of the 15 knees (87%) had knee joint survival with a mean Knee Society Score of 81 points (range 45–100 points) at a mean follow-up of 40 months (range 9–120 months). Five of seven knees treated with core decompression had a successful clinical outcome. One of the patients who failed core decompression later underwent osteochondral autograft transfer, and eight of nine knees treated with this modality had a successful outcome.

Conclusion

Overall, these results demonstrate that joint-preserving surgical treatment can successfully postpone the need for knee arthroplasty in selected patients with pre-collapse SPONK.

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Acknowledgments

No benefits have been received from a commercial party related directly or indirectly to the subject of this article. This study complies with all current relevant laws in the United States, where this report was produced.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Howard University Hospital, 2041 Georgia Avenue, Northwest, Washington, DC, 20060, USA

    Nyagon G. Duany

  2. Center for Joint Preservation and Reconstruction, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, 2401 West Belvedere Avenue, Baltimore, MD, 21215, USA

    Michael G. Zywiel, Mike S. McGrath, Junaed A. Siddiqui & Michael A. Mont

  3. Center for Osteonecrosis Research and Education, Johns Hopkins University Orthopaedics at Good Samaritan Hospital, Suite 201 GSH POB, 5601 Loch Raven Boulevard, Baltimore, MD, 21239, USA

    Lynne C. Jones

  4. Bonutti Clinic, 1303 West Evergreen Avenue, Effingham, IL, 62401, USA

    Peter M. Bonutti

Authors
  1. Nyagon G. Duany
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  2. Michael G. Zywiel
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  3. Mike S. McGrath
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  4. Junaed A. Siddiqui
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  5. Lynne C. Jones
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  6. Peter M. Bonutti
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  7. Michael A. Mont
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Correspondence to Michael A. Mont.

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Duany, N.G., Zywiel, M.G., McGrath, M.S. et al. Joint-preserving surgical treatment of spontaneous osteonecrosis of the knee. Arch Orthop Trauma Surg 130, 11–16 (2010). https://doi.org/10.1007/s00402-009-0872-2

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  • DOI: https://doi.org/10.1007/s00402-009-0872-2

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