Limits...
Spontaneous Osteonecrosis of the Knee: A Retrospective Analysis by Using MRI and DEXA

View Article: PubMed Central - PubMed

ABSTRACT

Objective:: Although there are many etiology and prediction for prognosis of spontaneous osteonecrosis of the knee (SONK) by using radiological examinations, these issue have not been clarified yet. Furthermore, most of the studies evaluated them by only radiological examination such as magnetic resonance imaging (MRI), bone mineral density (BMD) in dual-energy X-ray abosorptiometry (DEXA) or plain X-ray. Therefore, we focused our investigation on the measurements of the affected área in MRI and BMD in DEXA, and whether these results were conected with the cause and prognosis of SONK or not.

Method:: A consecutive case series of two groups composed of ten osteoporotic patients who were suffering from SONK was considered. Based on the severity or duration of pain, one group was treated with surgical procedure which was unicompartmental knee arthroplasty (UKA), the other received conservative treatment. Both groups underwent DEXA in their distal fêmur and próximal tíbia and all patients who took MRI measured the affected lesion in low and high intensity área on T2 weighted images. This data was analyzed from these areas and units.

Results:: Significant decrease in regional boné density of the affected femoral condyle compared to the unaffected side was observed. However, the boné mineral density in the affected side was similar in the non-operative and surgical group. The área of the lesion which showed in both low and high intensity indicated that the operation group was significantly larger than the conservative group on T2 weighted images.

Conclusion:: The cause and prognosis of SONK have a close relationship with the size of the affected lesion and decreased boné mineral density

No MeSH data available.


Related in: MedlinePlus

The study selection process. All patients are selected by their past history of illness and divided into two groups by the treatment protocol.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC5120381&req=5

Figure 1: The study selection process. All patients are selected by their past history of illness and divided into two groups by the treatment protocol.

Mentions: Between 2009 and 2013, we checked and treated twenty-five consecutive patients with SONK. We focused on healthy status, sex, age and duration of initial onset (Fig. 1), we excluded five patients who had past history of illness including Rheumatoid arthritis, diabetes, chronic kidney disease, alcoholics and steroid user which are the risk factor for fragility of bone. Those who fit our criteria were twenty patients, of which ten patients were given conservative treatment and others were treated with surgical procedures because of the severity of symptom or non-resolution of symptoms during 1 month bed rest for non-weight-bearing with NSAIDs and all of them had radiography, MRI of the knee and DEXA of the lumbar spine performed on them on the distal femur and proximal tibia 2 weeks after the onset of pain. This study was performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its amendments. Data analyses were performed as follows.


Spontaneous Osteonecrosis of the Knee: A Retrospective Analysis by Using MRI and DEXA
The study selection process. All patients are selected by their past history of illness and divided into two groups by the treatment protocol.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5120381&req=5

Figure 1: The study selection process. All patients are selected by their past history of illness and divided into two groups by the treatment protocol.
Mentions: Between 2009 and 2013, we checked and treated twenty-five consecutive patients with SONK. We focused on healthy status, sex, age and duration of initial onset (Fig. 1), we excluded five patients who had past history of illness including Rheumatoid arthritis, diabetes, chronic kidney disease, alcoholics and steroid user which are the risk factor for fragility of bone. Those who fit our criteria were twenty patients, of which ten patients were given conservative treatment and others were treated with surgical procedures because of the severity of symptom or non-resolution of symptoms during 1 month bed rest for non-weight-bearing with NSAIDs and all of them had radiography, MRI of the knee and DEXA of the lumbar spine performed on them on the distal femur and proximal tibia 2 weeks after the onset of pain. This study was performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its amendments. Data analyses were performed as follows.

View Article: PubMed Central - PubMed

ABSTRACT

Objective:: Although there are many etiology and prediction for prognosis of spontaneous osteonecrosis of the knee (SONK) by using radiological examinations, these issue have not been clarified yet. Furthermore, most of the studies evaluated them by only radiological examination such as magnetic resonance imaging (MRI), bone mineral density (BMD) in dual-energy X-ray abosorptiometry (DEXA) or plain X-ray. Therefore, we focused our investigation on the measurements of the affected área in MRI and BMD in DEXA, and whether these results were conected with the cause and prognosis of SONK or not.

Method:: A consecutive case series of two groups composed of ten osteoporotic patients who were suffering from SONK was considered. Based on the severity or duration of pain, one group was treated with surgical procedure which was unicompartmental knee arthroplasty (UKA), the other received conservative treatment. Both groups underwent DEXA in their distal fêmur and próximal tíbia and all patients who took MRI measured the affected lesion in low and high intensity área on T2 weighted images. This data was analyzed from these areas and units.

Results:: Significant decrease in regional boné density of the affected femoral condyle compared to the unaffected side was observed. However, the boné mineral density in the affected side was similar in the non-operative and surgical group. The área of the lesion which showed in both low and high intensity indicated that the operation group was significantly larger than the conservative group on T2 weighted images.

Conclusion:: The cause and prognosis of SONK have a close relationship with the size of the affected lesion and decreased boné mineral density

No MeSH data available.


Related in: MedlinePlus