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Total knee arthroplasty for osteonecrosis.

Michael A Mont1, Aiman Rifai, Keith M Baumgarten

  • 1Department of Orthopedic Surgery, The Johns Hopins Medical Institute, Baltimore, Maryland 21287, USA. rhondamont@aol.com

The Journal of Bone and Joint Surgery. American Volume
|April 10, 2002
PubMed
Summary

Total knee arthroplasty offers a successful treatment for femoral condyle osteonecrosis, with 97% of patients experiencing positive outcomes. Cemented implants and ancillary stems contributed to excellent results in this study.

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Area of Science:

  • Orthopedic Surgery
  • Biomaterials Science

Background:

  • Osteonecrosis of the femoral condyle presents limited treatment options, often necessitating total knee arthroplasty.
  • Previous research indicates suboptimal outcomes for total knee arthroplasty in osteonecrosis patients.

Purpose of the Study:

  • To evaluate the clinical and radiographic outcomes of total knee arthroplasty (TKA) specifically for osteonecrosis of the femoral condyle and/or tibial plateau.

Main Methods:

  • A cohort of 30 patients (32 knees) underwent cemented total knee arthroplasty between 1987 and 1996.
  • The study group comprised 24 women and 5 men, with a mean age of 54 years.
  • Etiologies included atraumatic osteonecrosis (n=22) linked to corticosteroid use and spontaneous osteonecrosis (n=8).
  • All patients received comprehensive clinical and radiographic follow-up, averaging 108 months post-surgery.

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Main Results:

  • A high success rate of 97% (31 of 32 knees) was observed.
  • The mean Knee Society score significantly improved from 54 preoperatively to 95 at final follow-up.
  • No progressive radiolucency was detected around prosthetic components, indicating implant stability.

Conclusions:

  • The study demonstrates excellent outcomes for total knee arthroplasty in treating osteonecrosis, contrasting with prior findings.
  • The use of cemented implants in all cases and appropriate ancillary stems is suggested as a key factor for these favorable results.