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Osteonecrosis of Knee

- Discussion:
    - commonly presents in females over age 60 years of age;
    - pain may or may not be associated w/ acute injury and may be worse at night;
    - these lesions often show articular degenerative changes, especially when lesions are large or when there is pre-existing varus deformities;

- Radiographs:
    - slight flattening of medial femoral condyle on both AP & lateral views
    - bone scan:
          - technetium 99 bone scan may reveal increased uptake in both femoral condyles and slightly increased in the proximal tibia;
    - MRI:
          - evidence of well localized osteonecrosis in lateral condyle & extensive involvement of the medial condyle;
          - T1 images show decreased signal;

- Treatment Options:
    - high tibial osteotomy:
          - indicated for small (less than 45%) AVN lesions of the medial femoral condyle in patients with a pre-existing varus deformity;
    - total knee arthroplasty:
          - indicated for older patients w/ signicant collapse and degenerative changes

Idiopathic osteonecrosis of the knee. Aetiology, prognosis and treatment.

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The survival of total knee arthroplasty in patients with osteonecrosis of the medial condyle.

Osteonecrosis of the knee. Diagnosis and outcome in 40 patients.

Osteonecrosis of the knee following laser-assisted arthroscopic surgery: a report of six cases.

Osteoarticular allografts to treat distal femoral osteonecrosis.

Size of osteonecrosis of the knee.

Clinical course and roentgenographic changes of osteonecrosis in the femoral condyle under conservative treatment.

Osteonecrosis of the femoral condyle after arthroscopic reconstruction of a cruciate ligament. Report of two cases.

Osteonecrosis of the knee.