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Total knee arthroplasty for steroid-induced osteonecrosis
1Department of Orthopaedic Surgery, Hospital of the University of Pennsylvania, Philadelphia 19104, USA.
The Journal of Arthroplasty
|September 4, 1999
Summary
Total knee arthroplasty (TKA) offers significant knee score improvement for patients with steroid-induced osteonecrosis. Despite a higher complication rate, TKA is a successful option for these chronically ill patients.
Area of Science:
- Orthopedic Surgery
- Rheumatology
- Biomedical Engineering
Background:
- Steroid-induced osteonecrosis of the knee is a challenging condition.
- Limited data exists on the outcomes of total knee arthroplasty (TKA) in this patient population.
- Patients often have severe underlying comorbidities.
Purpose of the Study:
- To evaluate the outcomes of TKA in patients with steroid-induced osteonecrosis of the knee.
- To assess the survivorship and complication rates of TKA in this specific group.
- To determine the functional improvement following TKA.
Main Methods:
- Retrospective review of 31 TKAs in 24 patients with confirmed steroid-induced osteonecrosis.
- Average follow-up of 64 months.
- Analysis of knee scores, revision rates, and complications.
Main Results:
- 92% of surviving knees showed significant improvement in knee scores.
- Five knees (16%) required revision surgery (3 aseptic loosening, 2 sepsis).
- Complications not requiring revision occurred in 19% of knees.
Conclusions:
- TKA can be a successful procedure for chronically ill patients with steroid-induced osteonecrosis.
- Survivorship to revision was 84% at 5 years.
- A slightly higher complication rate may be associated with underlying disease severity.