title: Postarthroscopy osteonecrosis of the knee.
abstract: OBJECTIVE
  Spontaneous subchondral osteonecrosis of the knee joint confined to a localized area of one condyle can occur after arthroscopic procedures. Meniscal tears, arthroscopic meniscectomy, and radiofrequency chondroplasty are aetiological factors in the development of osteonecrosis. The aim of this study was to investigate whether the incidence of osteonecrosis increased when mechanical or radiofrequency chondroplasty was used in conjunction with arthroscopic meniscectomy.
  
  
  METHODS
  In this prospective clinical trial, arthroscopic meniscectomy was the primary treatment in 75 patients (mean age 40 ± 13) with stage II and III degenerative changes on the articular cartilage. Patients had to meet the following criteria: 1) have preoperative MRI and plain film radiographs showing no evidence of osteonecrosis; 2) be symptomatic for at least 6 weeks before the preoperative MRI; and 3) have arthroscopically confirmed stage II or III chondral lesion. A preoperative MRI was performed for all patients. For treatment of chondral lesions, debridement with a shaver or chondroplasty with a monopolar RF energy system was used. Patients were divided into three treatment groups. Partial meniscectomy of the medial or lateral (or both) menisci was performed on all patients, but patients in group 2 additionally received mechanical debridement of the chondral lesion, and those in group 3 were additionally treated with RF chondroplasty. Patients in group 1 were treated with partial meniscectomy alone. Patients were re-examined after 6 months, at which time a repeat MRI was performed.
  
  
  RESULTS
  Development of osteonecrosis was detected during the postoperative MRIs of five patients: two in group 1, two in group 2, and one in group 3.
  
  
  CONCLUSIONS
  The addition of mechanical or RF chondroplasty to meniscectomy did not increase the number of patients with osteonecrosis. Also, RF chondroplasty, which is commonly proposed to be an aetiological factor, resulted in a decrease in the number of patients that developed osteonecrosis.
  
  
  METHODS
  II.
authors: Department of Orthopedics and Traumatology, Faculty of Medicine, Kırıkkale University, Yenimahalle Sağlık Caddesi, Merkez, 71100, Kirikkale, Turkey, meturker@yahoo.com.
authors: Mehmet
authors: M
authors: Türker
authors: Özgur
authors: Ö
authors: Çetik
authors: Meriç
authors: M
authors: Çırpar
authors: Serhat
authors: S
authors: Durusoy
authors: Barış
authors: B
authors: Cömert
mesh_terms: D000328:Adult; D001178:Arthroplasty / Q000009:adverse effects*; D001182:Arthroscopy / Q000009:adverse effects; D002357:Cartilage Diseases / Q000601:surgery*; D002358:Cartilage, Articular / Q000601:surgery; D005260:Female; D006801:Humans; D015994:Incidence; D007718:Knee Injuries / Q000175:diagnosis / Q000601:surgery*; D007719:Knee Joint / Q000473:pathology* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery*; D008875:Middle Aged; D010020:Osteonecrosis / Q000175:diagnosis* / Q000209:etiology; D011446:Prospective Studies