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Osteonecrosis of knee

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https://www.readbyqxmd.com/read/29665764/unicompartmental-knee-arthroplasty-for-spontaneous-osteonecrosis-of-the-knee-a-meta-analysis
#1
Julio J Jauregui, Christopher L Blum, Neil Sardesai, Craig Bennett, R Frank Henn, Farshad Adib
BACKGROUND: Spontaneous osteonecrosis of the knee (SONK) is a poorly understood but debilitating disease entity. Total knee arthroplasty (TKA) is the standard of care for those patients who fail conservative management, but considering SONK's predilection for affecting a single knee compartment, unicompartmental knee arthroplasty (UKA) appears to be a more tailored option. Unfortunately, conflicting data exist on the utility of UKA in SONK. Thus, the purpose of this study was to evaluate functional outcomes and revision rates of UKA in the setting of SONK...
May 2018: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/29663012/medial-joint-line-elevation-of-the-tibia-measured-during-surgery-has-a-significant-correlation-with-the-limb-alignment-changes-following-medial-unicompartmental-knee-arthroplasty
#2
Yuichi Kuroda, Koji Takayama, Kazunari Ishida, Shinya Hayashi, Shingo Hashimoto, Masanori Tsubosaka, Takehiko Matsushita, Takahiro Niikura, Kotaro Nishida, Ryosuke Kuroda, Tomoyuki Matsumoto
PURPOSE: This study aimed to determine the correlation between the change in joint line height calculated from the resected bone and insert thickness during surgery and the change in limb alignment following unicompartmental knee arthroplasty (UKA). It was hypothesized that joint line elevation is correlated with the change in limb alignment. METHODS: A total of 74 consecutive patients diagnosed with either isolated medial compartmental osteoarthritis (38 patients) or spontaneous osteonecrosis of the knee (36 patients) were included...
April 16, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29629588/reliable-outcomes-and-survivorship-of-unicompartmental-knee-arthroplasty-for-isolated-compartment-osteonecrosis
#3
B P Chalmers, K G Mehrotra, R J Sierra, M W Pagnano, M J Taunton, M P Abdel
Aims Primary (or spontaneous) and secondary osteonecrosis of the knee can lead to severe joint degeneration, for which either total or unicompartmental arthroplasty may be considered. However, there are limited studies analyzing outcomes of unicompartmental knee arthroplasties (UKAs) for osteonecrosis involving an isolated compartment of the knee. The aims of this study were to analyze outcomes of UKAs for osteonecrosis with specific focus on 1) survivorship free of any revision or reoperation, 2) risk factors for failure, 3) clinical outcomes, and 4) complications...
April 1, 2018: Bone & Joint Journal
https://www.readbyqxmd.com/read/29611159/perioperative-outcomes-and-short-term-complications-following-total-knee-arthroplasty-in-chronically-immunosuppressed-patients
#4
Gannon L Curtis, Morad Chughtai, Anton Khlopas, Jared M Newman, Assem A Sultan, Nipun Sodhi, Wael K Barsoum, Carlos A Higuera, Michael A Mont
BACKGROUND: Although there are studies regarding immunosuppressed patients undergoing total knee arthroplasty (TKA) for inflammatory arthritis or osteonecrosis, there is a paucity of studies evaluating immunosuppressed patients undergoing TKA for diagnoses other than these. MATERIALS AND METHODS: We identified all patients undergoing primary TKA for osteoarthritis from 2008-2014 in the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database...
March 29, 2018: Surgical Technology International
https://www.readbyqxmd.com/read/29589086/subchondral-stem-cell-therapy-versus-contralateral-total-knee-arthroplasty-for-osteoarthritis-following-secondary-osteonecrosis-of-the-knee
#5
Philippe Hernigou, Jean Charles Auregan, Arnaud Dubory, Charles Henri Flouzat-Lachaniette, Nathalie Chevallier, Helene Rouard
PURPOSE: Total knee arthroplasty (TKA) implanted in patients with secondary osteonecrosis (ON) related to corticosteroids have relatively poor outcome (20% revision rate) at a mean follow-up of only eight years. With the hypothesis that subchondral bone marrow injection might improve knees in these patients, we evaluated 30 patients who had bilateral knee osteoarthritis with severe joint space narrowing and received TKA in one knee and subchondral bone marrow concentrate injection in the contralateral knee...
March 27, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29582115/osteonecrosis-in-sickle-cell-disease-patients-from-bahia-brazil-a-cross-sectional-study
#6
Gildasio Daltro, Bruno Adelmo Franco, Thiago Batista Faleiro, Davi Araujo Veiga Rosário, Paula Braga Daltro, Vitor Fortuna
PURPOSE: The aim of this study was to describe the clinical features of osteonecrosis (ON) in sickle cell disease (SCD) patients in Bahia, a Northeast state with the highest prevalence of the disease in Brazil. METHODS: Between 2006 and 2017, 283 cases of osteonecrosis in SCD patients were enrolled to analyse the age at diagnosis, genotype, gender, pain, distribution of the lesions and disease staging. MRI and radiograph were obtained at the participation. RESULTS: Of the 283 SCD cases, 120 (42...
March 26, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29552689/characteristics-management-and-outcomes-of-spontaneous-osteonecrosis-of-the-knee-in-indian-population
#7
Nishit Bhatnagar, Siddharth Sharma, Virender Kumar Gautam, Ajeet Kumar, Anurag Tiwari
PURPOSE: Spontaneous osteonecrosis of the knee affects the medial femoral condyle in patients above 55 years of age. Many reports and studies are available from western countries. But there is a gross paucity of literature on spontaneous osteonecrosis of the knee (SPONK) in the Indian subcontinent, either it is under-reported or detected at a later stage. The aim of our study was to detect SPONK in Indian population and describe its characteristics, treatment, and outcome. MATERIAL AND METHOD: A prospective study was conducted over a period of three years...
March 18, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29523954/do-femoral-head-collapse-and-the-contralateral-condition-affect-patient-reported-quality-of-life-and-referral-pain-in-patients-with-osteonecrosis-of-the-femoral-head
#8
Yusuke Osawa, Taisuke Seki, Yasuhiko Takegami, Takehiro Kasai, Yoshitoshi Higuchi, Naoki Ishiguro
PURPOSES: The objectives of this study were to investigate patient-reported outcomes and referral pain at the first visit in patients with osteonecrosis of the femoral head (ONFH) and to clarify the influence of collapse of the femoral head and the contralateral condition. METHODS: The study included 105 patients (130 hips) with ONFH at the first visit, who were divided into two groups based on the presence of bilateral walking hip pain (bilateral group 25 patients, 50 hips) and unilateral hip pain (unilateral group 80 patients, 80 hips)...
March 9, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29469958/long-term-experience-with-intranasal-bevacizumab-therapy
#9
Johan Steineger, Terje Osnes, Ketil Heimdal, Sinan Dheyauldeen
OBJECTIVES/HYPOTHESIS: Long-term follow-up of intranasal bevacizumab therapy in hereditary hemorrhagic telangiectasia (HHT). STUDY DESIGN: Prospective, noncomparative study. METHODS: Patients treated for HHT-associated epistaxis by intranasal submucosal bevacizumab injections between June 2011 and August 2013 were included and followed prospectively. The effectiveness of the treatment was evaluated by the epistaxis severity score (ESS); the epistaxis intensity, frequency, and the need of blood transfusion (IFT) score; and hemoglobin levels...
February 22, 2018: Laryngoscope
https://www.readbyqxmd.com/read/29462407/transitional-changes-in-the-incidence-of-osteonecrosis-in-systemic-lupus-erythematosus-patients-focus-on-immunosuppressant-agents-and-glucocorticoids
#10
Kento Nawata, Junichi Nakamura, Kei Ikeda, Shunsuke Furuta, Hiroshi Nakajima, Seiji Ohtori, Shigeo Hagiwara, Yasushi Wako, Michiaki Miura, Yuya Kawarai, Masahiko Sugano, Kensuke Yoshino, Sumihisa Orita, Kazuhide Inage, Tsutomu Akazawa
Objective: The purpose of this study was to investigate transitional changes in the incidence of glucocorticoid-associated osteonecrosis in SLE patients, with a focus on immunosuppressive agent and glucocorticoid consumption. Methods: We retrospectively registered 185 SLE patients with 740 joints, who were newly diagnosed and hospitalized for initial high-dose glucocorticoid therapy from 1986 to 2015. Immunosuppressive agent, glucocorticoid dose, age, sex, organ lesion at hospitalization, complement (C3, C4, CH50) and anti-DNA antibody before initial glucocorticoid therapy, the frequency of use of anticoagulant and antilipidemic drugs, and incidence of osteonecrosis were documented...
February 14, 2018: Rheumatology
https://www.readbyqxmd.com/read/29316597/radiographic-classification-systems-for-osteonecrosis-of-the-knee-a-review-of-literature
#11
Assem A Sultan, William A Cantrell, Morad Chughtai, Prem N Ramkumar, Anton Khlopas, Jared M Newman, Nipun Sodhi, Suela Lamaj, Timothy C Wagner, Linsen T Samuel, Michael A Mont
Knee osteonecrosis is a rare, yet debilitating disease that can lead to knee joint destruction and can be associated with significant pain and disability. Various imaging modalities have different roles in the diagnosis, staging, management, and determination of the prognosis in knee osteonecrosis. Plain radiographic images can show gross joint destruction and secondary arthritic changes. In addition, magnetic resonance imaging (MRI) has become the gold-standard imaging modality to diagnose osteonecrosis. Multiple classification systems have been developed for knee osteonecrosis based on these imaging modalities...
December 22, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/29299471/outcomes-of-a-newer-generation-cementless-total-knee-arthroplasty-design-in-patients-less-than-50-years-of-age
#12
Michael A Mont, Chukwuweike Gwam, Jared M Newman, Morad Chughtai, Anton Khlopas, Prem N Ramkumar, Steven F Harwin
Background: Younger patients undergoing cemented total knee arthroplasty (TKA) may be at risk for lower implant survivorship and higher revision rates due to the historical increased prevalence of aseptic loosening and instability in this cohort. The recent advances of cementless TKAs may mitigate some of these complications. However, there is a paucity of studies reporting on patients who are under 50 years who have undergone a cementless TKA. Therefore, this study evaluated: (I) implant survivorship; (II) functional outcomes and complications; and (III) radiographic outcomes in patients who were less than 50 years of age and underwent cementless TKA...
December 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29202561/meniscal-extrusion-as-booster-of-osteoarthritis
#13
R Papalia, G Papalia, F Russo, L A Diaz, F Bressi, S Sterzi, V Denaro
Meniscal extrusion (ME) has shown to play a critical but still unclear role in osteoarthritis (OA) development. ME has been described as an important risk factor in the progression of knee OA, as it is involved in the thinning of articular cartilage, joint space narrowing, spontaneous osteonecrosis of the knee and subchondral bone marrow lesions. Meniscal damage of any degree of severity could cause ME in both compartments, but it is commonly associated with severe meniscal tears or root tears mainly in the medial meniscus...
December 27, 2017: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/29128233/cementless-total-knee-arthroplasty-in-knee-osteonecrosis-demonstrated-excellent-survivorship-and-outcomes-at-three-year-minimum-follow-up
#14
Assem A Sultan, Anton Khlopas, Nipun Sodhi, Mark L Denzine, Prem N Ramkumar, Steven F Harwin, Michael A Mont
BACKGROUND: Lack of consensus exists on the use of cementless total knee arthroplasty (TKA) in patients with knee osteonecrosis. Therefore, this study was conducted to evaluate (1) implant survivorship; (2) clinical outcomes and complications; and (3) radiographic outcomes of primary cementless TKA in knee osteonecrosis. METHODS: This study included 46 patients (49 knees) who had knee osteonecrosis and underwent primary cementless TKA and had a mean follow-up of 44 months (range 36-96)...
November 8, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29102568/mosaic-osteochondral-autograft-transplantation-versus-bone-marrow-stimulation-technique-as-a-concomitant-procedure-with-opening-wedge-high-tibial-osteotomy-for-spontaneous-osteonecrosis-of-the-medial-femoral-condyle
#15
Ken Kumagai, Yasushi Akamatsu, Hideo Kobayashi, Yoshihiro Kusayama, Tomoyuki Saito
PURPOSE: To evaluate the effects of osteochondral autograft transplantation (OAT) mosaicplasty as a concomitant procedure with opening-wedge valgus high tibial osteotomy (HTO) for spontaneous osteonecrosis of the medial femoral condyle (MFC) on clinical outcomes and cartilage status in comparison with bone marrow stimulation (BMS) by drilling, and to assess the relation between lesion size and postoperative cartilage status. METHODS: Fifty-eight patients with spontaneous osteonecrosis of the MFC were treated with opening-wedge HTO and a concomitant procedure of BMS (28 patients) or OAT (30 patients)...
January 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29051901/fresh-osteochondral-allograft-transplantation-for-spontaneous-osteonecrosis-of-the-knee-a-case-series
#16
Luís E P Tírico, Samuel A Early, Julie C McCauley, William D Bugbee
BACKGROUND: Spontaneous osteonecrosis of the knee (SONK) is a clinical entity identified by acute knee pain usually associated with joint effusion, with radiographic findings of a radiolucent defect on the weightbearing area of the femoral condyle. Conservative treatment is initially undertaken; however, surgical procedures are often necessary. Historically, surgical options have included core decompression, cartilage repair, high tibial osteotomy, or joint arthroplasty. Few studies in the literature have reported the use of fresh osteochondral allograft (OCA) for the treatment of SONK lesions...
October 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29050054/indication-criteria-for-total-knee-arthroplasty-in-patients-with-osteoarthritis-a-multi-perspective-consensus-study
#17
Jochen Schmitt, Toni Lange, Klaus-Peter Günther, Christian Kopkow, Elisabeth Rataj, Christian Apfelbacher, Martin Aringer, Eckhardt Böhle, Hartmut Bork, Karsten Dreinhöfer, Niklaus Friederich, Karl-Heinz Frosch, Sascha Gravius, Erika Gromnica-Ihle, Karl-Dieter Heller, Stephan Kirschner, Bernd Kladny, Hendrik Kohlhof, Michael Kremer, Nicolai Leuchten, Maike Lippmann, Jürgen Malzahn, Heiko Meyer, Rainer Sabatowski, Hanns-Peter Scharf, Johannes Stoeve, Richard Wagner, Jörg Lützner
Background and Objectives Knee osteoarthritis (OA) is a significant public health burden. Rates of total knee arthroplasty (TKA) in OA vary substantially between geographical regions, most likely due to the lack of standardised indication criteria. We set out to define indication criteria for the German healthcare system for TKA in patients with knee OA, on the basis of best evidence and transparent multi-stakeholder consensus. Methods We undertook a complex mixed methods study, including an iterative process of systematic appraisal of existing evidence, Delphi consensus methods and stakeholder conferences...
October 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28953137/human-immunodeficiency-virus-infection-and-hip-and-knee-arthroplasty
#18
Dimitrios Dimitriou, Mmampapatla Ramokgopa, Jurek R T Pietrzak, Dick van der Jagt, Lipalo Mokete
BACKGROUND: Modern management of human immunodeficiency virus (HIV) infection has afforded patients longevity while increasing the burden of arthroplasty procedures because of the increased risk of osteonecrosis, fragility fractures, and degenerative joint disease. Early publications on hip and knee arthroplasty in HIV-positive patients reported a high risk of complications, although some more recent publications demonstrated acceptable outcomes. Despite the widespread nature of the HIV pandemic, there is a paucity of literature addressing outcomes following joint arthroplasty in infected patients...
September 2017: JBJS Reviews
https://www.readbyqxmd.com/read/28934884/effect-of-a-rapidly-degrading-presolidified-10-kda-chitosan-blood-implant-and-subchondral-marrow-stimulation-surgical-approach-on-cartilage-resurfacing-in-a-sheep-model
#19
Angela D Bell, Mark B Hurtig, Eric Quenneville, Georges-Étienne Rivard, Caroline D Hoemann
Objective This study tested the hypothesis that presolidified chitosan-blood implants are retained in subchondral bone channels perforated in critical-size sheep cartilage defects, and promote bone repair and hyaline-like cartilage resurfacing versus blood implant. Design Cartilage defects (10 × 10 mm) with 3 bone channels (1 drill, 2 Jamshidi biopsy, 2 mm diameter), and 6 small microfracture holes were created bilaterally in n = 11 sheep knee medial condyles. In one knee, 10 kDa chitosan-NaCl/blood implant (presolidified using recombinant factor VIIa or tissue factor), was inserted into each drill and Jamshidi hole...
October 2017: Cartilage
https://www.readbyqxmd.com/read/28913557/improved-joint-line-restitution-in-unicompartmental-knee-arthroplasty-using-a-robotic-assisted-surgical-technique
#20
Yannick Herry, Cécile Batailler, Timothy Lording, Elvire Servien, Philippe Neyret, Sebastien Lustig
PURPOSE: Joint-line restitution is one objective of unicompartmental knee arthroplasty (UKA). However, the joint line is often lowered when resurfacing femoral implants are used. The aim of this study was to compare the joint-line height in UKA performed by robotic-assisted and conventional techniques. METHODS: This retrospective case-control study compared two matched groups of patients receiving a resurfacing UKA between 2013 and 2016 by either a robotic-assisted (n = 40) or conventional (n = 40) technique...
November 2017: International Orthopaedics
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