Abstract
Knee osteonecrosis is a severe disease rapidly leading to end-stage osteoarthritis,
which was classified into three categories: spontaneous, secondary, and postarthroscopy.
To understand postarthroscopy osteonecrosis of the knee, all the three types of knee
osteonecrosis have to be deepened. This article reviewed spontaneous and secondary
osteonecroses of the knee, with special focus upon postarthroscopy osteonecrosis,
which is a rare form, affecting patients operated for arthroscopic knee surgery, most
commonly for meniscectomy. Due to its rarity, patients and surgeons are often unprepared
for this complication. A correct diagnosis is essential for appropriate treatment,
and also to determine if a preexisting osteonecrosis was present, avoiding medicolegal
sequelae, although many authors agree that osteonecrosis (both spontaneous and postarthroscopy)
represent unpreventable and unpredictable conditions. In spontaneous osteonecrosis,
the treatment is defined according to the size and the degree of the lesion, whereas
in postarthroscopy osteonecrosis, the size of the lesion has no prognostic value,
and therefore, the choice of the correct treatment is based more on the timing of
the diagnosis. A diagnostic and therapeutic algorithm was outlined on the basis of
the actual knowledge.
Keywords
osteonecrosis - knee - arthroscopy - meniscectomy - treatment
