Ragland, Phillip S MD; Dolphin, Michael DO; Etienne, Gracia MD, PhD; Mont, Michael A MD
Abstract: The knee joint is the second most common site for osteonecrosis with approximately a 10% incidence of the disease in the femoral head. Two separate entities exist: (1) spontaneous osteonecrosis of the knee (SPONK) and (2) secondary osteonecrosis of the knee. They are differentiated by age of presentation, associated risk factors, location, laterality, and condylar involvement. Each of these entities has several distinct surgical treatment options. These include arthroscopic debridement, core decompression, osteochondral allografting and autografting, osteotomy, unicompartmental knee arthroplasty, and total knee arthroplasty. It is essential to diagnose these 2 entities as early as possible to use appropriate treatment to avoid osteoarthritis, joint destruction, and ultimately joint collapse. In a following article, we discuss the evaluation, indications/contraindications, techniques, results, and possible future treatments of these two entities: SPONK and secondary osteonecrosis.
Techniques in Knee Surgery. 3(3):163-169, September 2004.