Effects of intravenous iloprost therapy in patients with bone marrow oedema of the foot and ankle.
OBJECTIVE
Bone marrow oedema (BMO) is a multifactorial condition. The conservative treatment options include immobilisation of the affected region and systemic intravenous iloprost therapy. Whereas many studies confirm the positive effect of iloprost therapy in larger joints, e.g. knee and hip, there have been few studies of BMO in smaller areas such as the ankle joint or midfoot. The purpose of this study is to show that treatment with iloprost leads to positive long-term outcomes for BMO of the foot and ankle.


METHODS
Twenty-three patients with BMO of the ankle joint or midfoot, Association Research Circulation Osseous (ARCO) stages 1-2, were included in this study. A questionnaire was used to record the Ankle-hindfoot, Kaikkonen, SF-36 and VAS scores before and after iloprost therapy. In addition, all patients underwent MRI for radiological follow-up monitoring 3 months after treatment.


RESULTS
A significant improvement in function based on the ankle-hindfoot and Kaikkonen scale was demonstrated after iloprost therapy. In 22 patients, follow-up MRI after 3 months showed complete regression of the oedema.


CONCLUSIONS
Based on the positive results of our study, we recommend treatment with iloprost for BMO of the upper ankle joint and foot at ARCO stages 1-2.
Department of Traumatology and Orthopaedics, Charité University Hospital, Berlin, Germany, roehner.ortho@web.de.
Eric
E
Röhner
Timo
T
Zippelius
David
D
Steindl
Jasmin
J
Fussi
Carsten
C
Perka
D000843:Ankle Joint / Q000187:drug effects; D018771:Arthralgia; D001855:Bone Marrow Diseases / Q000188:drug therapy* / Q000473:pathology; D004487:Edema / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D033023:Foot Joints / Q000187:drug effects; D006801:Humans; D016285:Iloprost / Q000008:administration & dosage / Q000627:therapeutic use*; D007262:Infusions, Intravenous; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D012189:Retrospective Studies; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use*
D014665:Vasodilator Agents; D016285:Iloprost