title: Treatment of Secondary Osteonecrosis of the Knee With Local Debridement and Osteoprogenitor Cell Grafting.
abstract: Secondary osteonecrosis of the knee (SOK) affects young individuals with chronic diseases and corticosteroid use. We report a series of young patients in whom the osteonecrotic lesion was openly debrided, and concentrated bone marrow osteoprogenitor cells (OPCs) harvested from the iliac crest were placed in the defect. Twelve patients (fourteen knees) have undergone debridement and grafting of distal femoral osteonecrotic lesions. Age at surgery averaged 23 years. Follow-up averaged 5 years. None of the patients have undergone further surgery, or were taking medications for ipsilateral knee pain. Knee Society Score and Knee Function Score averaged 87 and 85 respectively. The technique of open debridement and osteoprogenitor cell grafting for SOK is relatively simple, efficacious, has low morbidity, and does not preclude future interventions.
authors.affiliation: Department of Orthopaedic Surgery, Stanford University, Stanford, California.
authors.forename: Stuart B
authors.initials: SB
authors.lastname: Goodman
authors.affiliation: Department of Orthopaedic Surgery, Stanford University, Stanford, California.
authors.forename: Katherine L
authors.initials: KL
authors.lastname: Hwang
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000009:adverse effects*; D000328:Adult; D016026:Bone Marrow Transplantation; D016025:Bone Transplantation; D003646:Debridement; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007085:Ilium / Q000601:surgery; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D010020:Osteonecrosis / Q000139:chemically induced / Q000601:surgery*; D011859:Radiography; D033581:Stem Cell Transplantation; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones
keywords: avascular necrosis; femur; knee; osteonecrosis; osteoprogenitor cell grafting