title: Total knee arthroplasty for steroid-induced osteonecrosis.
abstract: There have been only a few reports that evaluate the outcome of total knee arthroplasty in patients with steroid-induced osteonecrosis of the knee. We retrospectively reviewed 31 total knee arthroplasties in 24 patients with confirmed steroid-induced osteonecrosis of the knee. The average follow-up was 64 months. Of surviving knees, 92% had significant improvement in knee scores. Five knees (16%) required a revision procedure. Reasons for revision were aseptic loosening in 3 knees and sepsis in 2 knees. Complications not requiring revision occurred in 6 of 31 knees (19%). Survivorship of total knee arthroplasty to revision in patients with steroid-induced avascular necrosis of the knee was 84% at 5 years. Although there was a slightly higher complication rate, this may, in part, be due to the severity of the patients' underlying disease processes. Total knee arthroplasty can be a successful procedure for chronically ill patients with steroid-induced osteonecrosis.
authors.affiliation: Department of Orthopaedic Surgery, Hospital of the University of Pennsylvania, Philadelphia 19104, USA.
authors.forename: R M
authors.initials: RM
authors.lastname: Seldes
authors.forename: V
authors.initials: V
authors.lastname: Tan
authors.forename: G
authors.initials: G
authors.lastname: Duffy
authors.forename: J A
authors.initials: JA
authors.lastname: Rand
authors.forename: P A
authors.initials: PA
authors.lastname: Lotke
mesh_terms: D000328:Adult; D000368:Aged; D019645:Arthroplasty, Replacement, Knee; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects; D006801:Humans; D007717:Knee; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D010020:Osteonecrosis / Q000139:chemically induced / Q000601:surgery*; D011474:Prosthesis Design; D012189:Retrospective Studies
chemical_list: D005938:Glucocorticoids