Skip to main content
Top
Published in: Archives of Orthopaedic and Trauma Surgery 8/2008

01-08-2008 | Orthopaedic Surgery

Spontaneous osteonecrosis of the lateral femoral condyle of the knee: a report of 11 cases

Authors: Toshihiro Ohdera, Satoshi Miyagi, Masami Tokunaga, Eiji Yoshimoto, Shusaku Matsuda, Hiroya Ikari

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 8/2008

Login to get access

Abstract

Background

Spontaneous osteonecrosis (SON) of the lateral femoral condyle of the knee joint is very rare and there have been only a few articles about this condition.

Materials

We reviewed data for 11 patients (7 men, 4 women) with unusual SON of the lateral femoral condyle of the knee. The average age of patients at onset was 61.9 years (range 47–76 years). No patient had underlying disease or had undergone steroid therapy, although one underwent lateral meniscectomy.

Results

According to Aglietti’s radiographic classification, three patients had stage 1 disease, two had stage 2 disease, three had stage 3 disease, one had stage 4 disease, and two had stage 5 at first examination. The average alignment of affected limbs on standing was 5.9° valgus (range 0°–11°). Although the osteonecrotic lesion was seen on the lateral side, the mechanical axis passed the medial compartment in three patients. Six patients were treated conservatively and the remaining five required surgery, which consisted of lateral unicompartmental knee arthroplasties.

Conclusion

The pathology of the necrosis of the lateral femoral condyle was considered to be different from that of the medial femoral condyle regarding clinical features, limb alignment, and radiographic findings.
Literature
1.
go back to reference Ahlbäck S, Bauer GC, Bohne WH (1968) Spontaneous osteonecrosis of the knee. Arthritis Rheum 11:705–733PubMedCrossRef Ahlbäck S, Bauer GC, Bohne WH (1968) Spontaneous osteonecrosis of the knee. Arthritis Rheum 11:705–733PubMedCrossRef
2.
go back to reference Al-Rowaih A, Wingstrand H, Lindstrand A et al (1990) Three-phase scintimetry in osteonecrosis of the knee. Acta Orthop Scand 61:120–127PubMed Al-Rowaih A, Wingstrand H, Lindstrand A et al (1990) Three-phase scintimetry in osteonecrosis of the knee. Acta Orthop Scand 61:120–127PubMed
3.
go back to reference Aglietti P, Insall JN, Buzzi R, Deschamps G (1983) Idiopathic osteonecrosis of the knee: aetiology, prognosis and treatment. J Bone Joint Surg Br 65:588–597PubMed Aglietti P, Insall JN, Buzzi R, Deschamps G (1983) Idiopathic osteonecrosis of the knee: aetiology, prognosis and treatment. J Bone Joint Surg Br 65:588–597PubMed
4.
go back to reference Ashraf T, Newman JH, Evans RL, Ackroyd CE (2002) Lateral unicompartmental knee replacement survivorship and clinical experience over 21 years. J Bone Joint Surg Br 84:1126–1130PubMedCrossRef Ashraf T, Newman JH, Evans RL, Ackroyd CE (2002) Lateral unicompartmental knee replacement survivorship and clinical experience over 21 years. J Bone Joint Surg Br 84:1126–1130PubMedCrossRef
5.
go back to reference Cameron HU, Botsford DJ, Park YS (1997) Prognostic factors in the outcome of supracondylar femoral osteotomy for lateral compartment osteoarthritis of the knee. Can J Surg 40:114–118PubMed Cameron HU, Botsford DJ, Park YS (1997) Prognostic factors in the outcome of supracondylar femoral osteotomy for lateral compartment osteoarthritis of the knee. Can J Surg 40:114–118PubMed
6.
go back to reference Ecker ML, Lotke PA (1995) Osteonecrosis of the medial part of the tibial plateau. J Bone Joint Surg-A 77:596–601 Ecker ML, Lotke PA (1995) Osteonecrosis of the medial part of the tibial plateau. J Bone Joint Surg-A 77:596–601
7.
go back to reference Forst J, Forst R, Heller KD, Adam G (1998) Spontaneous osteonecrosis of the femoral condyle: causal treatment by early core decompression. Arch Orthop Trauma Surg 117:18–22PubMedCrossRef Forst J, Forst R, Heller KD, Adam G (1998) Spontaneous osteonecrosis of the femoral condyle: causal treatment by early core decompression. Arch Orthop Trauma Surg 117:18–22PubMedCrossRef
8.
go back to reference Kidwai AS, Hemphill SD, Griffiths HJ (2005) Spontaneous osteonecrosis of the knee reclassified as insufficiency fracture. Orthopedics 28:333–336 Kidwai AS, Hemphill SD, Griffiths HJ (2005) Spontaneous osteonecrosis of the knee reclassified as insufficiency fracture. Orthopedics 28:333–336
9.
go back to reference Lotke PA, Ecker ML (1983) Osteonecrosis-like syndrome of the medial tibial plateau. Clin Orthop Relat Res 176:148–153PubMed Lotke PA, Ecker ML (1983) Osteonecrosis-like syndrome of the medial tibial plateau. Clin Orthop Relat Res 176:148–153PubMed
10.
go back to reference Lotke PA, Ecker ML (1985) Osteonecrosis of the knee. Orthop Clin North Am 16:797–807PubMed Lotke PA, Ecker ML (1985) Osteonecrosis of the knee. Orthop Clin North Am 16:797–807PubMed
11.
go back to reference Marmor L (1984) Osteonecrosis of the knee: Medial and lateral involvement. Clin Orthop Relat Res 185:195–196PubMed Marmor L (1984) Osteonecrosis of the knee: Medial and lateral involvement. Clin Orthop Relat Res 185:195–196PubMed
12.
go back to reference Marmor L (1984) Lateral compartment arthroplasty of the knee. Clin Orthop Relat Res 186:115–121PubMed Marmor L (1984) Lateral compartment arthroplasty of the knee. Clin Orthop Relat Res 186:115–121PubMed
13.
go back to reference Motohashi M, Morii T, Koshino T (1991) Clinical course and roentgenographic changes of osteonecrosis in the femoral condyle under conservative treatment. Clin Orthop Relat Res 266:156–161PubMed Motohashi M, Morii T, Koshino T (1991) Clinical course and roentgenographic changes of osteonecrosis in the femoral condyle under conservative treatment. Clin Orthop Relat Res 266:156–161PubMed
14.
go back to reference Murray PB, Rand JA (1993) Symptomatic valgus knee: the surgical options. J Am Acad Orthop Surg 1:1–9PubMed Murray PB, Rand JA (1993) Symptomatic valgus knee: the surgical options. J Am Acad Orthop Surg 1:1–9PubMed
15.
go back to reference Ohdera T, Tokunaga J, Kobayashi A (2001) Unicompartmental knee arthroplasty for lateral gonarthrosis: midterm results. J Arthroplasty 16:196–200PubMedCrossRef Ohdera T, Tokunaga J, Kobayashi A (2001) Unicompartmental knee arthroplasty for lateral gonarthrosis: midterm results. J Arthroplasty 16:196–200PubMedCrossRef
16.
go back to reference Perez Carro L, Gomez Cimiano FJ et al (1996) Core decompression and arthroscopic bone grafting for avascular necrosis of the knee. Arthroscopy 12:323–326PubMedCrossRef Perez Carro L, Gomez Cimiano FJ et al (1996) Core decompression and arthroscopic bone grafting for avascular necrosis of the knee. Arthroscopy 12:323–326PubMedCrossRef
17.
go back to reference Rape D, Seil R, Kohn D et al (2004) Imaging of early stages of osteonecrosis of the knee. Orthop Clin N Am 35:293–303CrossRef Rape D, Seil R, Kohn D et al (2004) Imaging of early stages of osteonecrosis of the knee. Orthop Clin N Am 35:293–303CrossRef
18.
go back to reference Uchio Y, Ochi M et al (2001) Intraosseous hypertension and venous congestion in osteonecrosis of the knee. Clin Orthop Relat Res 384:217–223PubMedCrossRef Uchio Y, Ochi M et al (2001) Intraosseous hypertension and venous congestion in osteonecrosis of the knee. Clin Orthop Relat Res 384:217–223PubMedCrossRef
19.
go back to reference Yamamoto T, Bullough PG (2000) Spontaneous osteonecrosis of the knee: the result of subchondral insufficiency fracture. J Bone Joint Surg Am 82:858–886PubMedCrossRef Yamamoto T, Bullough PG (2000) Spontaneous osteonecrosis of the knee: the result of subchondral insufficiency fracture. J Bone Joint Surg Am 82:858–886PubMedCrossRef
Metadata
Title
Spontaneous osteonecrosis of the lateral femoral condyle of the knee: a report of 11 cases
Authors
Toshihiro Ohdera
Satoshi Miyagi
Masami Tokunaga
Eiji Yoshimoto
Shusaku Matsuda
Hiroya Ikari
Publication date
01-08-2008
Publisher
Springer-Verlag
Published in
Archives of Orthopaedic and Trauma Surgery / Issue 8/2008
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-008-0623-9

Other articles of this Issue 8/2008

Archives of Orthopaedic and Trauma Surgery 8/2008 Go to the issue