title: Osteonecrosis of the knee - which joint preservation procedures work?
abstract: There is no consensus with respect to the best procedures to preserve the knee joint in patients with osteonecrosis of the knee. We performed a systematic review of the literature between 1999 and 2012. Only 10 of 1057 studies met our inclusion criteria. Core decompression prevented additional surgical treatment in pre-collapse knees with a failure rate of 10.4% (7 of 67 knees). Autogenous and osteochondral grafts decreased the need for additional surgery in both pre-collapse (0%, 20 of 20) and post-collapse knees (10.5%, 8 of 76 knees). Although these results are quite promising multi-center randomized trials are needed to identify the optimal procedures to treat this disease.
authors.affiliation: Department of Orthopaedic Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, California.
authors.forename: Jay R
authors.initials: JR
authors.lastname: Lieberman
authors.forename: Arya G
authors.initials: AG
authors.lastname: Varthi
authors.forename: Gregory G
authors.initials: GG
authors.lastname: Polkowski
mesh_terms: D019645:Arthroplasty, Replacement, Knee; D016025:Bone Transplantation; D002356:Cartilage / Q000637:transplantation; D019299:Decompression, Surgical; D018450:Disease Progression; D006801:Humans; D007719:Knee Joint; D010020:Osteonecrosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D011859:Radiography
keywords: autogenous grafts; clinical outcomes; core decompression; osteochondral grafts; osteonecrosis of knee