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CC BY-NC-ND 4.0 · Joints 2017; 05(04): 229-236
DOI: 10.1055/s-0037-1608666
Review Article
Georg Thieme Verlag KG Stuttgart · New York

Postarthroscopy Osteonecrosis of the Knee: Current Concepts

Francesco Di Caprio
1   Operating Unit of Orthopedics and Traumatology, AUSL of Romagna, Ceccarini Hospital, Riccione, Italy
,
Renato Meringolo
1   Operating Unit of Orthopedics and Traumatology, AUSL of Romagna, Ceccarini Hospital, Riccione, Italy
,
Maria Adiletta Navarra
1   Operating Unit of Orthopedics and Traumatology, AUSL of Romagna, Ceccarini Hospital, Riccione, Italy
,
Massimiliano Mosca
2   Second Orthopedics and Traumatology Clinic, Rizzoli Orthopedic Institute, Bologna, Italy
,
Lorenzo Ponziani
1   Operating Unit of Orthopedics and Traumatology, AUSL of Romagna, Ceccarini Hospital, Riccione, Italy
› Author Affiliations
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Publication History

Publication Date:
06 November 2017 (online)

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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